Finding into death of Mr V

73y · Male·Combined effects of cerebrovascular accident and subsequent iatrogenic related intracerebral haemorrhage and subarachnoid haemorrhage

A 73-year-old man presented to ED with acute facial droop and speech difficulty on 5 September 2020. He was misdiagnosed with Bell's palsy despite clinical features suggestive of stroke. A non-contrast CT brain (inadequate for stroke evaluation) was performed instead of CT perfusion. He was discharged with prednisolone. Three days later, he returned with worsening symptoms and was found to have a left internal carotid artery occlusion with large infarct. Emergency endovascular clot retrieval was performed but the artery was perforated, causing iatrogenic intracranial haemorrhage from which he died. Earlier stroke recognition would have enabled timely intervention with better procedural outcomes and reduced complication risk, though death was ultimately due to a recognised procedure complication.