Case of CVA with Left sided hemiparesis affecting lower limb more than upper limb Chief Complaints Weakness of left upper and lower limb since 3days Facial deviation to right side since 3days Vitals PR-70 BPM BP-150/90mmhg Spo2-96% at RA Afebrile Physical Examination Dysarthria+ Hypertonic in Left UL and LL Power R L UL 5/5. 3/5 LL. 5/5. 1/5 Reflexes R. L Biceps. 2+. 3+ Triceps. 2+. 3+ Knee . 2+. 3+ Ankle. 2+. 3+ Plantar. Flexor. mute Forehead wrinkles present b/l Eye is unable to close against resistance in Left side, normal on right Angle of mouth deviated to right Cerebellar couldn't assess



Nice case narration.. Few things are missing.. 1. Age 2. Gender 3. Previous risk factors related to stroke 4. For stroke, it is more appropriate to mention date and time, instead of just mentioning 3 days.. This is a case of rt mca malignant infarct in mri brain and mra showing cutoff at m1 mca on rt side. Must evaluate for etiology, vessel imaging is already done, now look for cardiac causes Appropriate 2ndry prophylaxis as per etiology. Stroke care unit, Physiotherapy, rehabilitation, are next goal

Rt MCA acute infarction. Already passed 3 days. Suggest medical management as per stroke peotocol,DVT prophylaxis,physio

Acute CVA with left hemiparesis with facial palsy ( bells phenomenon) Large massive MCA infarction Need observation in ICU Explain the prognosis Start anti hypertensives tab.coversyl plus BD Inj.heparin 5k sc Inj.citicholine IV BD Inj.taxim 1gm IV BD Tab.ecosprin 150 mg od Tab.clopitab 75 mg Tab.atorva 80 mg daily one night Monitor bp GRBs Temp .and other vitals Take expert opinion from neurologist

Right MCA territory large infarction Had this patient presented with in 24 hours angiographic intervention would have resulted in remarkable recovery

cva As a emergency treatment you can use Brhat Vata chintaamani rasa crushed & mixed with Dashamularishta kept under tongue repeatedly for once in 20-30min

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