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.

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A case of right hemiplegia ,probably cerebral stroke due to hypertension. An Ultrasound abdomen will help in finding out the cause of abdominal distension. Transverse slit like umbilicus is in favour of Ascitis. Other possibilities are a full bladder , localised collection or an ovarian cyst

Sir flanks empty. Lower abdominal swelling firm. Ascites unlikely yes more in favour of full bladder.

Fist rule out retension of urine secondary to cns involment second pelvic organ malignancy incuding ovary uterous bladder as setra go for usg abdoman to see pathology and ct brain to rule out stroke and brain mets if advance malignancy ttreat according

Hemiplagia right, advised MRI brain, treat accordingly.

With the history of involvement of CNS, it is most likely to be retention of urine with distended bladder. Catheterisation of the bladder would clear the doubt before going for any investigation.


Apparently pt presnting w rt sided hemipresis w facial dermopathy,likely facial palsy. Ascitis or abd. mass might b present, so malignancy shld be excluded. Pt has HTN, bowel/ bladder r invled. CVA w myelopathy may be the couse due to metastasis. proper work up to be done> cbc,astic fluid study, MRI brain,cx spine, CECT abdmen.

CVA both ant. and mid cerebral artery involved. Sensory int capsule or thalamus. Bladder retention. May be spinal shock. BP reactionary. CT brain and proceed.

It's case where multiple organ involved first rould out stroke and secondary spine from ovary/uterine as for lower abdomen swelling it may be urinary retention so for diagnosis is concern in GERIATRIC subject both malignancy and CVA is common this patient have hypertension so urgent CT brain and CA rould out to make sure and treat according

It looks Hemiplegia, Regarding abdomen it could be. Renal dysfunction so get Renal profile & U S abdomen & proceed further

Stroke with urinary retention

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