Case Study 14: Perth to Cambridge (UK)

Sir Charles Gardner Hospital Perth to Cambridge University Hospital

A 84 year-old male Professor from Cambridge United Kingdom was traveling to Australia for work when he was admitted in February 2013 to Sir Charles Gardner Hospital Perth with sudden onset of expressive and receptive dysphasia, right facial droop, right hemiparesis and right hemisensory and visual neglect.

A Computer Tomography (CT) brain scan and CT angiography showed an acute left Middle Cerebral Artery (MCA) territory infarct with an occlusive thrombus identified on one of the opercular branches of the left MCA, there was no intracranial haemorrhage or mass.  A Magnetic Resonance Imaging (MRI) scan also identified ischemic changes in left inferior gyrus and insular cortex and their was a distal right brachiocephalic artery and proximal right subclavian artery mixed atheroma causing 50-70% subclavian artery stenosis and right vertebral artery occlusion from C6.

The patient was thrombolysis with tissue plasminogen activator (tPA) and heparin before transiting to warfarin. Other complications included recurrent chest and urinary infection were treated and with ongoing physiotherapy and speech therapy his expressive and receptive dysphasia improved.

Due to his age, comorbidities and the flight time to the United Kingdom Medical Connect conducted a thorough risk assessment. Medical Connect identified the potential hazards and with relevant controls in place he was successfully repatriated to Cambridge University Hospital for further rehabilitation.