stroke at 35 yr age with past h/o 2 misscarraige at 7 moa

??apla syndrome. kindly advice further workup and treatment. Chief Complaints right sided hemiparesis, aphasia since 2 days blurring if vision, headache since 5 days History 2 misscarraige at 7 moa, 5 years back no history of dvt/thromboplebitis/heart disease, tb known case of dm2 since 5years on insulin Vitals t normal pr 92/min bp 130/90 mmhg rs bl clear CVS nad spo2 98% on room air rbs controlled by plain insulin 14/14/14 Physical Examination right sided hemiparesis, power 2/5 right sided facial palsy (umnl) aphasia altered sensorium Investigations ldh 800 hb 12.5 wbc 7600 plt 4,26,000 Diagnosis right sided hemiparesis Management Aspirin 150 0-1-0 clopido 75 0-1-0 atorvas 0-0-1 inj plain insulin 14/14/14

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Young stroke.2 miscarriage. Needs young stroke work up including vasculitis screening,ANA,ANA profile,test for thrombophilia including protein C ,protein S,antithrombin 111,cardiolipin ,beta 2 glycoprotein, fasting homocysteineANCA,Angiotensinconverting enzyme,MRI angiogram or CT angio,Cardiac evaluation. Inaddition to the present med add DVT prophylaxis,physio.Further management after the young stroke work up.

Thank you doctor

Long standing diabetic with on regular insulin Event of hemiplegia is CVA Known cerebrovascular complications of diabetics Here area involved is pan cerebral infarct as in periventricular and white matter in parietal temporal and occipital lobes lt side This pt can only be treated by conservative line Keeping vitals under control and bsl by regular insulin with titration 9f units As bsl are likely to rise as pt need to receive heavy doses of steroids and anticoagulants Inj clexan o.6bd Inj prednisolone 30mg iv inj solumedrol drip Inj Ceftriaxozone bd If any response seen start physiotherapy

Thanx dr Simi Anwar Haq

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This is stroke in young Need detail evaluation with underlying diabetes may be a risk factors Also need to look for any syndrome Clinical presentation slight different than of classical stroke, raised suspicion about same..!! Look for 2ndry causes leading to stroke


Adv CT ANGIO and. Complete neuro workup required.

MR angio a ANA profile cause stroke at that young age is unlikely. Also check for procoagulant states ...serum homocystiene levels.

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