right intracerebral haemorrhage and left middle cerebral artery cerebrovascular accident on a background of infective endocarditis, end stage renal failure, multiple myeloma and ischaemic and valvular heart disease
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Wayne Shore, 55, died from right intracerebral haemorrhage and left middle cerebral artery stroke complicating infective endocarditis, end-stage renal failure, and multiple myeloma. He was subject to a Level 1 Inpatient Treatment Order under the Mental Health Act following a devastating left MCA stroke that caused cognitive impairment and suicidal ideation. On day 6 of admission, he developed a right temporal intracerebral haemorrhage, likely from a mycotic aneurysm secondary to his endocarditis. Neurosurgical intervention was contraindicated due to ongoing anticoagulation effects needed for his artificial heart valves. A multidisciplinary team appropriately decided on palliative care given his poor prognosis (months expected survival) and devastating bilateral strokes with negligible neurological recovery prospects. The coroner found his care was appropriate and of high standard, with valid mental health orders.
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