Australian visitor receives coordinated care for transient ischemic attack and hip fracture in Foshan
Neurology, orthopedics, anaesthesia and critical care teams planned hip replacement around the patient's cerebral and cardiac risks.
Published by CareAtlas · Editorial policy
An Australian visitor with neurological symptoms, a right femoral neck fracture and severe coronary disease received multidisciplinary treatment at Foshan Hospital of Traditional Chinese Medicine. The January 13, 2025 account describes assessment, hip replacement and neurocritical monitoring.
Neurological assessment revealed several risks
The visitor developed right-sided weakness and difficulty speaking at 8 am and arrived at the emergency department at 6 pm. Neurology activated the stroke-centre pathway.
Non-contrast brain CT, CT angiography and CT perfusion excluded a large-vessel occlusion. Further assessment favoured a transient ischemic attack, alongside the right hip fracture and three-vessel coronary disease.
A history of Alzheimer's disease, prior cerebral infarction and severe cognitive impairment complicated communication, history-taking and examination.
A hip operation with a critical-care plan
The fracture required surgery, but the combined conditions made it high risk. Orthopedics, anaesthesia, neurology, cardiology and critical care specialists discussed the case and spoke with the family.
They selected right total hip replacement. Before surgery, the neurocritical care team assessed cerebral blood flow and planned perioperative management, including close observation in the neurological intensive care unit afterwards.
The orthopedic and anaesthetic teams completed the hip replacement in 67 minutes.
Monitoring supported return to rehabilitation
After surgery, the patient entered neurological intensive care. Staff used transcranial Doppler and bedside critical-care ultrasound to follow cerebral circulation and cardiac function.
Blood pressure and fluid management were adjusted to maintain brain and heart perfusion. These measures were intended to reduce perioperative neurological risk in a patient with existing vascular disease.
The following day, the patient returned to the geriatric orthopedic ward and began walking with a rehabilitation therapist's guidance.
Geriatrics and neurocritical care continued to follow progress alongside the orthopedic rehabilitation programme, with neurological and cardiovascular treatment plans in place. The hospital reported good recovery at publication, and the patient and family expressed appreciation for the coordinated care.