Question

Mr. Q, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Q has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.

1. Explain the rationale for each manifestation present at this stage. Which manifestation(s) is (are) most significant in the diagnosis of CVA?

Answer 1

The narrowing of blood vessels have lead to decrease in blood supply to brain causing damage to tissue due to lack of oxygen. This increased pressure has lead to severe headache.Further narrowing has raided the blood pressure simultaneously. The damage caused to tissue has further lead to affecting the center of speech,arm control and muscle weakness .

The manifestation like slurred speech,weaknes on one side (right arm and right face),facial asymmetry.The patient have experienced FAST (Facial drooping, Weakness in Arm,Slurred Speech and brought to hospital immediately.Along with this the angiogram revealed occlusion of blood vessels in brain and damaged tissue indicates the diagnosis of CVA