CVA
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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read complete h/o then answer A 32 year old patient came with chief complaints of right sided weakness of ul an ll since last 4 days and difficulty in articulation since last 4 days deviation of face to left side patient was aa 4 days back when he developed weakness of rt ul and LL, which was sudden in onset at 9am in morning just half an hour after he came out of bathroom difficulty in articulation but he is able to understand and is able to communicate in broken words while laughing or speaking his moth is deviated to left and there is spilling of saliva and feeds, no h/o chest pain, palpitations, night sweats, pnd, breathlessness, RHD or any valvular heart disease in past, no h/o altered smell, abnormal eye movements, no change in facial sensations, no hearing difficulty, no neck fall, no swallowing difficulty past h/o known Hypertensive on t/t since 2 months taking steroids for migrating joint pain renal biopsy at young age of 20 hepres zooster on left abdominal wall 4 months back not diabetic general examination P 84/min normal character, normo volumic, with no radio radial or radio femoral dealy other pulsations felt BP 140/80 in right arm supine position JVP 9cm RR18/min temp afebrile rest normal systemic cn 7 involved umn type on right side With absece of nasolabial fold rest Normal tone increased in right ul and ll power 0/5 both rt ul and ll reflexes brisk biceps, triceps, supinator knee and ankle plantar extensor on rt what is your complete diagnosis? please give reason? how will you treat?
Dr. Niket Mantri2 Likes14 Answers - Login to View the image
74yrs/M PMHx of Uncontrolled HTN presented to ED with Sudden impairment of mental status,left sided weakness and dysarthria.His BP was 200/100 on presentation,HR -110/mt.Neurological examination revealed left facial drop,left sided hemiparesis.DIAGNOSIS AND SUGGEST MANAGEMENT PLAN?
Dr. Prashant Ved3 Likes9 Answers - Login to View the image
this gentleman presented with sudden onset of slurring if speech. associated was facial weakness. no limb weakness. DD and treatment?
Dr. Saumya Mittal3 Likes20 Answers - Login to View the image
62 male no comorb previous,came w h/o rt side ul weakness n ll weakness,deviation towards rt, slurred speech... o/e bp 200/100,p 80,rr 18.cns-concious,alert (power rt u.l 0/5,rt l.l 2/5.left 5/5 ul n ll),rs clear, cvs s1s2.patient developed fever spike of 99f, cbc-hb 14,wbc 22000,plt 300.rft,lft-nad.ct brain was done attached. rx n further plan of mx plz? thank u..
Dr. Kamran Ghm1 Like16 Answers - Login to View the image
Here is 75 year old female,has developed right sided,n numbness,weakness and tingling sensation,loss of movements in both right hand and and right leg since 10days,difficulty in speech,uncontrol bowel and bladder,after the above symptoms she has developed a swelling in lower abdomen,as shown in photo which is non tender,and firm in consistentency.Her vitals are not normal,Bp is 170/100mmHg.Plz kindly help in dx and treatment aspect.
Ravindra Kumar S Chauhan1 Like18 Answers