Diplopia & Vertigo
Chief Complaint A 59 y/o male presented with headache, diplopia & vertigo for 1 month. History He has h/o headache for 7-8 months Vitals All Vitals are wnl. Examination Pupils normal, impaired corneal reflex on left side, left horizontal nystagmus on left gaze, Facial sensory loss to pain on left side. Investigations Brain MRI revealed an acute stroke in the right caudal pons. CT angiography shows a thrombus in the proximal basilar artery. Treatment What do you opine?
Acute stroke in Right causal pons due to to thrombus in proximal basilar artery As the history is of one month. Continue blood thinner take neuro -physician and neuro surgeon for brain ededema ,to save the mildly affected neurons to minimize the ultimate loss using vit B12 and steroids and as per the guidelines neurologists
? CEREBRAL VASCULOPATHY .. ? CEREBRAL PATHOLOGY.. NEED'S.. CTCE STUDY.. ANGIOGRAPHY.. NEUROLOGISTS OPINION..
Presentation is long duration of 1 month, Basilar artery thrombosis on angiography In view of chronic presentation, it is not amenable for thrombolysis or angiographic intervention Adv Conservative treatment Antiplatelet agent Statin for cholesterol reduction Antihypertensive to control blood pressure if it is raised
59 YEARS MALE PATIENT HAS HEADACHE SINCE 7 MONTHS WITH VERTIGO DIPOLOPIA NYSTAGMUS CT ANGIOGRAPHY SHOWS IN DISTAL POST CEREBRAL ARTERY M R I SCAN BRAINE NEUROSURGECAL CONSULTATION NEURO OPHTHALMOLOGY CONSULTATION
* Cerebral pathology Conservative treatment. Surgical intervention required after proper assessment and evaluation Needs further investigation to conclude . Antihypertensive STATIN. Aspirin. Regular monitoring and constant evaluation required.
Cerebral thrombosis. Find out the cause of thrombus formation. Consult Betul Surgeon.
CT Angiography advice Thrombus may be due to Acute Stroke T/t Antiplatlet drugs Statin drugs to reduce Cholesterol Antihypertensive drugs
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