March 31, 2009

Stroke of left parietal temporal

A 71-year-old woman presents with aphasia and severe right sided hemiparesis greater in the arm than the leg. Her eyes deviate to the left. CT scan shows Ischaemic type of stroke on left parietal temporal region. [Taken and Modified from Question 389, Physical Diagnosis Pretest® Self-Assessment and Review Fourth Editio, Jo-Ann Reteguiz, M.D., Beverly Cornel-Avendaño, M.D, Mcgraw-Hill Medical Publishing Division Pretest® Series]

1)What vessel is most likely involved in this stroke? Justify (4m)
2)What is aphasia and explain the type of aphasia that the patient most likely have (3m)
3)Outline the pharmacological treatment in this patient (3m)


Answer

1)What vessel is most likely involved in this stroke? Justify
-Left Middle Cerebral artery, inferior division.
a)Hemiplegia@ hemiparesis greater in arm and leg
b)Aphasia
c)Eyes deviated to the hemispheric site of lesion

2)What is aphasia and explain the type of aphasia that the patient most likely have
-Acquired loss of of production or comprehension of spoken and/or written language secondary to brain damage.
-Wernicke aphasia (Inability of Patient to understand and give appropriate reply or action. Nonsense words in reply to question)


3)Outline the pharmacological treatment in this patient
-anticoagulants ( Heparin, warfarin)
-fibrinolytic agents (Tissue plasminogen activator) or
-anti platelet agent (Aspirin, Ticlopidine, clopidogrel, dypiridamole)


Tazkirah!!

When trouble toucheth a man, He crieth unto Us (in all postures)- lying down on his side, or sitting, or standing. But when We have solved his trouble, he passeth on his way as if he had never cried to Us for a trouble that touched him! thus do the deeds of transgressors seem fair in their eyes!.[ Q10:12]

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