Daniela Trasca, Vlad Claudiu Stefanescu and Inimioara Mihaela Cojocaru

A 81-year-old female patient suffering from type II diabetes mellitus, atrial fibrillation, hypertension and who neglected taking any medication at home, was referred to our clinic from the "St. Pantelimon" Hospital, where she had been brought by her family one day earlier, because of severely altered state of consciousness. Upon examination she was comatose – 3 pts. on the Glasgow Coma Scale (E1V1M1), had midriatic pupils, was tetraplegic and had abolished reflexes. Brain CT revealed bilateral massive stroke – right medial cerebral artery and the entire left hemisphere. Although rare, massive bilateral stroke may have developed in the context of the patient's untreated atrial fibrillation, and also hypertension, diabetes mellitus and old age. Other factors may include: stress, smoking, TIA, giant cell arteritis, sick sinus syndrome, infective endocarditis, left atrial myxoma

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