ACUTE ISCHEMIC STROKE.(INFARCT IN RIGHT CEREBRAL HEMISPHERE-FRONTAL AND PARIETAL LOBE

 Case History and Clinical Findings

CHIEF COMPLAINTS: PATIENT CAME WITH CHIEF COMPLAINTS OF LEFT LOWER LIMB WEAKNESS SINCE YESTERDAY MORNING(10/08/23)

C/O LEFT UPPER LIMB WEAKNESS SINCE 25 DAYS

C/O DEVIATION OF MOUTH TO RIGHT SIDE SINCE YESTERDAY MORNING(10/08/23)

HISTORY OF PRESENTING ILLNESS: PATIENT WAS APPARENTLY ASYMPTOMATIC TILL 25

DAYS AGO THEN HE DEVELOPED LEFT UPPER LIMB WEAKNESS WHICH WAS SUDDEN IN ONSET GRADUALLY PROGRESSIVE(FROM DISTAL TO PROXIMAL) FOR WHICH HE USED HERBAL MEDICATION AND HE HAD C/O WEAKNESS OF LEFT LOWER LIMB AND DEVIATION OF MOUTH TO RIGHT SIDE SINCE YESTERDAY MORNING

NO C/O HEADACHE SEIZURES VOMITINGS,LOOSE STOOLS, PAIN ABDOMEN FEVER BLURRING OF VISION, DIPLOPIA.

H/O LEFT UPPER LIME WEAKNESS 5 YEARS AGO FOR WHICH HE USED HERBAL MEDICATION.

HO RTA 4 YRS AGO (RIGHT UPPER LIMB AND LEFT SHOULDER INJURY)

H/O PULMONARY TB 3 YRS AGO(ON ATT FOR 6 MONTHS) NOT A K/C/O DM,HTN,CAD, EPILEPSY, ASTHMA.

GENERAL EXAMINATION:

THE PATIENT IS CONSCIOUS, COHERENT, COOPERATIVE, WELL ORIENTED TO TIME, PLACE AND PERSON, MODERATELY BUILT AND NOURISHED SPEECH SLURRED VITALS:

BP: 100/60 MMHG

PR: 63 BPM

RR: 16 CPM

RBS:98 MG/DL

TEMP: 98,4 =

CVS: $1, 52 HEARD, NO MURMURS RS: BAE +, NVBS, NO ADDED SOUNDS PIA: SOFT, NON TENDER ONS:

CRANIAL NERVES:7TH CRANIAL NERVE

MOTOR SYSTEM:

TONE-RIGHT(UL-NORMAL,LL-NORMAL)

LEFTUL-DECREASED LL-DECREASED)

POWER-RIGHT(UL-5/5 LL-5/5)

LEFT(UL-0/5, LL-3/5)

REFLEXES: B T SK A PT

RIGHT ++++++-E

LEFT---++-E

COURSE IN THE HOSPITAL :

83 YRS MALE WAS ADMITTED WITH ABOVE MENTIONED COMPLAINTS. NECESSARY EXAMINATIONS AND INVESTIGATIONS WERW DONE AND DIAGNOSED AS ACUTE ISCHEMIC STROKE THE PATIENT WAS CONSERVATIVELY MANAGED. THE SYMPTOMS SUBSIDED

MRI DONE ON 11/08/23

IMPRESSION:

1. MULTIPLE SMALL ACUTE INFARCTS IN RIGHT CEREBRAL HEMISPHERE PREDOMINANTLY IN FRONTAL AND PARIETAL LOBES
2. CHRONIC INFARCTS IN THE RIGHT PARIETAL AND FRONTAL LOBE.

2DECHO DONE ON 11/08/23:

EF:60% TRIVIAL TR/AR,NO MR

NO RWMA,NO AS/MS,SCLEROTIC AV

GOOD LV SYSTOLIC FUNCTION

DIASTOLIC DYSFUNCTION,NO PAH/PE

DIAGNOSIS 

ACUTE ISCHEMIC STROKE.(INFARCT IN RIGHT CEREBRAL HEMISPHERE-FRONTAL AND PARIETAL LOBE

Treatment Given(Enter only Generic Name)

1. TAB.ECOSPIRIN 75MG PO/HS
2. TAB.MVT PO/OD

Advice at Discharge

1. TAB.ECOSPIRIN 75MG PO/HS
2. TAB.MVT PO/OD