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Case presentation on STROKE

A case study on STROKE or cerebrovascular accidents.

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Case presentation on STROKE

  2. 2.  SUBJECTIVE DATA A male patient of age 44 years old was admitted in the hospital on 26/7/17 with chief complaints of :  One episode of seizures for 3min on 25/6/17  Vomiting since 2days:15-20 episodes  Decreased appetite  H/o difficulty in walking and weakness of limbs  H/o present illness: o Loss of appetite since 5days o k/c/o seizure disorder and on T.eptoin(100mg) since 3years H/o past illness: k/c/o HTN since 3 months
  3. 3. OBJECTIVE DATA Department of biochemistry : Day 1 Day 2 Normal values Creatinine 4.0mg/dL 3.9mg/dL 0.9-1.3mg/dL BUN 26mg/dL 22mg/dL 6.0-20.0mg/dL s.Chloride 75mmol/L 72mmol/dL 98-107mmol/dL PROVISIONAL DIAGNOSIS:  Metabolic Encephalopathy.  HTN.  CKD-stageIV
  4. 4. DEPARTMENT OF HEMATOLOGY: abnormal Normal  PCV 37.3% 40.0-50.0%  MCHC 36.7g/L 31.5-34.5g/L  Total count 19,400cells/ 4,000-10,000 Differential count:  neutrophils 87% 40-75%  lymphocytes 10% 20-40%
  5. 5. ECG:  Probably MI(lateral)  Incomplete right bundle branch block.  Slightly depressed ST segment(lateral,anterior)  ST segment depression(inferior).  Negative T wave(lateral).  prolonged QT  Probably abnormal ECG. CT scan of brain:  No abnormality detected inn brain at present study.  Soft tissue swelling in frontal region.
  6. 6. ASSESMENT: Based on subjective and objective data, it was finally diagnosed as cerebro vascular accident. PLAN TREATMENT GOAL:  Maximize persons functional abilities and level of independence.  Provide intensive rehabilitation.  Provide extensive training and education for the person and the family about the disease and medications.  Rebuilt persons quality of life.
  7. 7. TREATMENT Drug Generic name Dose Route Frequency Inj.Levipil Levetirace- tam 500mg IV BD Inj.Optineuro n vitB complex 1 Amp in 100ml Ns IV - Inj.pan Pantaprazol e 40mg IV OD T.cilaheart Cilnidipine 10mg P/O BD T.Librium Chlordiazep oxide 25mg P/O BD T.Telma Telmisartan 40mg P/O OD Syp.Potchlor KCl 25ml P/O TID
  8. 8. T.Cinmoral forte Trypsin,chy motrypsin 1mg P/O BD T.Amlodipin e Amlodipine 5mg P/O BD T.Artamine Clonidine HCl 0.1mg P/O TID T.Met-XL Metoprolol 50mg P/O OD
  9. 9. MONITORING PARAMETERS:  EEG monitoring can be useful to detect different brain states.  Tran jugular Doppler monitoring.  Brain tissue oxygen monitoring.  Level of consciousness, respirations, motor ability and strength.  Other monitoring-Head CT sacn,MRI.
  10. 10. PATIENT COUNSELLING:  Because of injury to brain from stoke pt may notice problems with changes in behavior, memory, muscle spasm, paying attention, swallowing, talking, thinking and depression is common.  Take the medicines as per prescription.  Diet-Avoid salty and fatty foods.  Smoking and Alcohol consumption should be ceased.  Try to stay away from stressful conditions.  Call the doctor if u have any problem because of drugs