Question

Neurological Consultation Reason for the Consultation: This 57 year old woman was admitted through the ER after she suddenly lost her balance and fell while dressing for work. After the fall, the patient was unable to walk as a result of right-sided weakness. No loss of consciousnes was reported, although she did experience a sudden impairment of speech (i.e. slurring). She denied visual loss or sensory disturbances but complained of mild to moderate temporal cephalgia before onset of symptoms. History: Patient's history includes treatment for hypertension and one previous hospita admission for transient ischemic attack. The TIA was characterized by mild visual loss and right-sided weakness which resolved within 10 hours. Neurologic Exam: Neurologic examination revealed flattening of the right nasolabial fold; other cranial nerves appeared intact. Monoplegia of the patient's right upper extremity was noted, as was paresis of the right lower extremity, with consequent unsteady gait. Her speech was poorly articulated, and patient's attempted verbal responses suggested aphasia. She demonstrated no confusion or disorientation; mental state appeared normal. Impression: Diagnostic procedures included EEG, cerebral angiography, brain scan, and CSF analysis. The diagnostic impression formulated for this patient was CVA. Question: Why was the patient previously hospitalized? progressive muscle atrophy Oright sided paralysis sudden deficient supply of blood to the brain. recurring seizures 16

Answer 1

Answer ; Sudden deficient supply of blood to the brain.

Reason ; In this case study the patient was previously complained and got into hospital with ischemic attack. So the previous hospitalization should not be referred as the complaint of right side paralysis, But her present situation might referred as right side paralysis.