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

Comments

Post a Comment

Popular posts from this blog

50 yrs old F with fever and chills following MHD

Image
  This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment  C HIEF COMPLAINTS :  50 year old female , came to medicine department  with complaints of pedal edema, shortness of breath and decreased urine output. HISTORY OF PRESENTING ILLNESS: Patient was apparently  asymptomatic 8 months later developed,  BILATERAL  PEDAL EDEMA with BILATERAL HAND EDEMA, Then she was admitted in Nalgonda hospital , where she was given drugs for 5 days but there was no improvement,  and referred to hyderabad  hospital . She was diagnosed with CKD and started dia
Read more

My Experience with General Cellular And Neural Cellular Pathology In a Case based Blended Learning Ecosystem's CBBLE

Welcome to my blog! I am Penukonda Daniya Menaz , an enthusiastic medical student from India. Here, I will share fascinating real-life cases that have not only expanded my knowledge of history taking and clinical examination but also improved my patient interaction skills and overall approach to patient care. These cases have been immensely valuable in shaping my medical journey, and I am thrilled to share them with you. Join me as we explore the captivating world of patient care, where each interaction offers opportunities for learning, personal development, and making a positive impact on the lives of those we serve. Thank you for embarking on this incredible journey with me! CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER  NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AV
Read more

Batch- 2020(UG) neurology cases

  https://ananyanayak2911.blogspot.com/2022/06/70-yr-old-with-recurrent-cva.html?m=1 https://aswin1052.blogspot.com/2022/06/case-45ymale-with-co-altered-sensorium.html?m=1 https://anupreethireddy.blogspot.com/2022/06/75-year-old-male-came-with-loss-of.html?m=1 https://anupreethireddy.blogspot.com/2022/06/53-year-old-female-came-with-dizziness.html?m=1 Original - 1   https://gsadhguna2002.blogspot.com/2022/12/gen-med-case-discussion.html?m=1 Repeated-1 https://manishreddy21.blogspot.com/2022/12/december-29th-general-medicine-elog-hi.html?m=1 Original-2 https://shreyagaddam.blogspot.com/2022/07/a-73-year-old-female-patient-who-is.html?m=1 Repeated - 2 https://anishareddy24.blogspot.com/2022/12/a-73-year-old-female-patient-who-is.html?m=1 https://gaayatri53.blogspot.com/2022/12/55-year-old-male-with.html?m=1 https://krishnaswaraliv62.blogspot.com/2023/04/general-medicine-case-discussion_18.html?m=1 https://mrinmayeey74.blogspot.com/2023/01/40yr-old-female-with-psychosis.html?m=1 https://9
Read more