A 54-year-old right-handed patient with no morbid history.
He was admitted 6 h after starting severe dysarthria, right eye deviation, hemiplegia, brachio-crural hemiplegia, hemianesthesia and left hemianopsia.
The rest of her examination showed no other abnormalities.
CT scan showed early signs of right MMI.
The possibility of progression to a MCMI and the possible need for HD were discussed with the family.
The family received care and accepted the intervention.
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The etiologic study was negative.
At 24 h, the patient was in superficial murmur without mydriasis or appearance of Babinski on the right.
A CT scan was performed.
Due to the progression of the clinical picture and CT, it was decided to perform HD, which was performed without complications.
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The patient was conscious and extubated within 24 h.
There were no complications.
The patient recovered mobility of the left ventricle, achieved mobility and was discharged after 22 days.
Aspirin (325 mg/day) was started on the seventh day.
The patient remained in neurorehabilitation at home and was able to walk in 3 months.
At the fourth month, the bone platelet was installed and discharged on the fifth day.
At 8 months she had a seizure, phenytoin was started (300 mg/day).
At 2 years of age, she lives independently but limited to her home: help from a bed, eats alone, dresses herself and goes to the bathroom helped by her lady (modified Rankin scale= 3).
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When asked both patients and their families individually whether they would undergo surgery again after having suffered the experience, they answered affirmatively.
