A 60yrs old male patient came in emergency on 14/03/18 with H/o sudden onset of left sided weakness(hemiplegia) on 9/3/18,having C/o slurred sppech,unable to walk,mouth deviation with G.weakness.He is a K/c/o HTN and DM for which he is taking regular medicine. N/h/o - COPD/trauma or ny other medical illness. O/e CNS - conscious but disoriented,Pupils - B/l small size reactive,GCS - E3V4M5,Bp - 130/80mmhg,BSR - 368mg/dl. LVEF - 35-40% urea - 128,creat-1.41,Hb-18.6,Platelet counts - 122,PCV-54.5,RBC count - 6,Serum triglycerides - 185,HDL - 31,VLDL - 37.Coagulation profile normal.Dx n Mx??



Acute right PCA and MCA infarct ? Embolic

Rt.Mca territory watershed Infarction out of window period LOOK FOR LARGE VESSEL STENOSIS PRODUCING WATERSHED INFARCTION DO MRI ANGIO IMAGING EXTRACRANIAL AND INTRACRANIAL POSSIBILITY OF uncontrolled HYPERGLYCEMIA POLYCYTHEMIA Hemodynamic stroke treatment- dual antiplatelet insulin infusion (bring bsl <150) Hydration with normal saline Physiotherapy and rehabilitation.

Thank u sir

Hypertension bleed arf decomposition craniotomy supportive

Give intravenous 25percent glucose first and observe. Commonest reason correctable is low sugar in diabetic patient. If no change treat as any other case of stroke

Sir mri rupture anurysim. DSA IS Help ful. Neuro physicio Start inj. Manni

I agree with Dr S Khosya

What is value of serum potassium?

Lt MCA territary multiple embolic infarct with AKI Antiplatelet Blood sugar control Hydration BP monitoring Carotid Doppler

Most probable diagnosis in hypertensive bleed but CVT and AVM should be ruled out and investigate coagulation profile...

Intracranial hemorrhage with intra ventricular extension. (Considering CT scan image).

Sir,its a MRI no haemorrhage seen

Cva ( ich) Give mannitol, IV fluids, control of hypertension, control of blood sugar by insulin, prevention of development of bed sore and aspiration pneumonia, ryles tube feeding

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