Case Study 2: Sydney to Cyprus

Royal Prince Alfred Hospital Sydney to Larnaca General Cyprus

A 66-year-old female who arrived in Australian from Cyprus was, within 24-hours of arrival, found on the floor in a drowsy state, unable to move her left side and with slurred speech.

A CT-brain scan showed an established infarct in the right middle cerebral artery (MCA), with hypo-density of the anterior middle artery territory and right basal ganglia. CT-angiography showed the absence of flow in the right MCA. A repeat CT-brain showed evidence of hemorrhagic transformation in the initial period, and she was unable to be thrombolysis.

The stroke was thought to be cardioembolic as she was also found to be in atrial fibrillation. An echocardiogram showed hypertrophied left ventricle with moderate global hypokinesics but no intra-cardiac thrombolysis.

Over the next two weeks she showed clinical improvements with her level of conscious, however, she remained densely hemiplegic and her long-term prognosis was considered poor.

The family did not have health insurance cover for the situation (considered a pre-existing condition) and with limited family funds for rehabilitation in Australia a cost benefit analysis was conducted by Medical Connect to obtain funding.  Family contributions and a private donation made the repatriation possible and she was successfully returned home to family.

At twelve months the patient can mobilise with the aid of a walking stick and the family are pleased with her progress.