Question

Lase Study acute stroke presenting as speech arrest Matching 2. Mat This 63 year old right-handed male was well until early on the morning of admission, when he had a 5 minute spell of tingling in the right cheek, followed by inability to speak, He remained alert and had intact memory of the events. He was able to communicate with hand gestures, but noted during transport to the hospital that his right hand was not functioning properly. He could not write with either the right or the left hand. His speech returned during transport to the hospital, less than 60 minutes after the episode's onset. There was a history of Micronase-treated adult onset diabetes mellitus, and a 5 year history of arterial hypertension (high blood pressure). treated with Vasotec. He was alert and oriented, with paucity of speech (very little), and some hesitation in word-finding. He had a mild right hemiparesis (weakness), affecting triceps and wrist extensor muscles. Serum glucose was 166, but all other blood chemistry and blood tests were normal. EKG showed evidence of left ventricular hypertrophy (enlarged heart) and a 24 hour Holter monitor was normal. Chest x-ray was normal except for a tortuous aorta (abnormal shape or path). MRA was normal. Myocardial infarction (heart attack) was ruled out. He was started on intravenous heparin, then converted to warfarin. Over the next 7 days, the deficits slowly resolved. 1. List each abnormal symptom that is related to the nervous system. 2. For each symptom list all of the possible regions (that we have studied) in the CNS that could be affected/damaged. Be sure to include right and left where appropriate. CNS Region Symptom 3. A stroke is the sudden death of nerve tissue in a localized area (within one specific area. Please be more specific than "left or right lobe") due to inadequate blood flow. Using the information from your answers in the previous two questions, describe exactly where in the CNS this patient's stroke occurred. Page 7 of 7

Answer 1

1, Acute stroke appear suddenly and worsen rapidly.
abnormal symptoms include
-Very little speech
-Hesitation in word-finding
-Mild right hemiparesis
-triceps and wrist extension muscle affected
2, Very little speech-left side of the brain
Hesitation in word finding-frontal region of the left hemisphere
mild right hemiparesis -left side of the brain
triceps and wrist extension muscle- radial nerve
3, the patient has a history of diabetes and arterial hypertension for the last 5 years on medication. a subtype of stroke is infarction and stroke and hemorrhage. patient myocardial infarction sue to heart abnormal condition cause thrombi and emboli. when there is an absence of cerebral circulation due to obstruction it causes brain injury or damage. It worsens the condition suddenly and cause a transient ischemic attack and cause sudden interruption of blood flow to the particular area of the brain. It causes weakness, numbness, paralysis, aphasia, slurred speech, etc. The right side of the body weakness affects the left side of the brain.