Slurred speech with Hypertension

A 66 year old male presented to OPD once again with slurred speech and difficulty in walking History H/O similar presentation like a month before presented with slurred speech and BP in range of 210/137mmHg and had undergone a NCCT head which revealed Diffuse cerebral atrophy ?Chronic infarcts, he was then put on Telista CL and Nulong 10 at night etc later he discontinued medcines Vitals His BP today is 206/134 mmHg Pulse 81 RBS 117 mg/dl Hb1c - 6% LDL - C - 117 Non HDL 134 Management I have restarted the patient on following - Cap Rozudoc Gold 10 at bedtime, Tab Telista CL OD Tab Nulong 10 OD after dinner Tab Dytor 5 OD Multivitamin syrup Piracetam 800 BD PPI + Prokinetic 30 mins BBF Advised for visit to physiotherapist too and a salt restricted diet Please guide me for appropriate line of management for this patient

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Old age pt with uncontrolled hypertension and senile atrophic brain and noncompliant as drop out the treatment hence varient hypertension aggravated cerebral stroke Your line seems to be in right direction But I will like to add ecosprin 150mg 1od and tab revorxuciban 10mg so as to keep thrombus dissolved

Thanx dr Ashok Leel
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Chronic hypertension with Cerebral Trophy and others related complications. Needs further investigation and evaluation to conclude particularly angiography of brain , consideration of. Cerebral condition. Regular monitoring and constant evaluation required. Physiotherapy and reassurance will be more beneficial. Ecosprin 150mg od may add.

Thanks Dr Dinesh Gupta
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GERIATRIC CASE .. WITH .. ? SEVERE .. HT .. WITH .. CEREBRAL ATROPHY .. WITH .. ASSOCIATED .. COMPLICATIONS ..

Tnx Dr Vipin Bihari Jain sir
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Sir,it could be a case of Transient ischaemic attack (TIA).But the elevation in BP might point towards an Ischemia. Addition of Aspirin & clopidogrel together can be taken into secondary consideration.Mostly only clopidogrel would be enough rather than dual platelet therapy. Since CT doesn’t show any acute hemorrhagic changes sudden BP reduction can be deferred till a definitive cause is identified. But I won’t disagree with a Rx of clinidipine, Telmisartan. Would advise for a neurology consult along with MRI angiogram and carotid Doppler.

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The present episode minor stroke/ TIA.TIA duration of symptoms is important which is not mentioned. Needs regular antiplatelets with statin. Needs good control of Hypertension. MRI is the ideal investigation

He has severe hypertension He needs antihypertensive medications - your choice of medication is good Monitor blood pressure

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SUGGESTIVE. OF SECONDARY. TO SEVERE. CONSTANT HYPERTENSION...

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Slurred speech Mri angio Opinion of neurologist

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Diffuse cerebral Atrophy is the cause

Thank you doctor
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slurring of speech Rx saraswata churna or any of vacha preparation with vatanulomana drugs

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