Hemorhagic infarct case

[snermeti]

Dear Doctor,
I owuld like to know abt a case i have come across
The patient is my bother-in-law.
In 1998 he had a head ache and had nausiatic feeling when we rushed to hospital after the Ct scan he was diagonised Hemohageic infarct.

then he was put on anti- convulsant treatment (i.e Eptoin ) for four years and the then the tablets was stopped.

he was alright for so many years.

suddenly on 26th of nov 2007  he got convulsion in the morning 9:00 while driving a motorbike he didnt get hurt and was saved by the person sitting behind him

he got next attack on the same day evening 7:00"oclock
then we shifted him to hospital again as soon as we reached hospital he got one more attack at 10:00 o'clock
he was there under treament and mean while he got 5 more convultions
Docs suggested MRI Venogram
and the reports of MRI and CT Scan is as below

CT SCAN
The Ct findings are suggestive of gliosis involving left temporal lobe with focal dilation of temporal horn of left lateral ventricle

MRI-VENOGRAM
Well defined hyperintense lesion is seen in left temporal region on T2WI
Irregular(18mm X 26mm) hypo intense lesion is seen in left frontal region and appears isointense on T22WI & hyper dense on CT section favoring hemorrhage with edema.
Brain stem strusctures & cerebellar hemisphere appear normal C-V function appears normal
Two –D TOF MR Venogram shows almost non-visualization of anterior 2/3 of superior sagittal sinus with poor visualization of left transverse sinus. Inferior sagittal sinus also shows poor flow signal right transverse & sigmoid sinuses appear unremarkable internal veins, vein of galen and straight sinus appear normal.
Opionion : The MR findings shows left frontal haemorrhage with oedema, represents, haemorrahage venous infarct, secondary to superior sagittal sinus thrombosis.
Left transverse sinus probably  appears hypoplastic.
Kindly comment on the same

[snermeti]

Dear Doctor,
Thanx for the advice,
ya we are regulary doing his follow up and they are talking his PT on every 3rd day......
how do we know the cause....
coz i've done what ever was possbile
Thanks
Warm regards
Seema

[Caliber2005]

Hi,
Your question of whether or not can it relapse depends on what condition has caused this hemorrhage.
He should take his medicine regularly. Exercise daily and do lifestyle changes.
Investigations and follow up with doctor's should be periodical.
Bye.

[snermeti]

Thank you for the comment
My brother in law is fine now discharged frm hospital on 6th of dec 2007  and docs have told to take medicines anticoagulant

some medicines like
vlaporin
frisium
rantec
folic acid
warf
eptoin
are going on
He was consious at the time of hospitalization
and also doc have told tha the'll be ready to work after 10 days of normal rest at home
i am only worried abt his future life still he is not married he is of 34 yrs
and what abt the health can it relapse again if yes then again what conditions etc....

[Caliber2005]

Hi Snermeti,
How is your brother-in-law doing?
It suggests there was earlier a TIA in year 1998.
There is always a risk of patient having stroke, if he suffered a TIA earlier. Repeated convulsions suggest there was increased pressure inside the brain. This can be due to either a bleed, thromboembolic phenomenon with oedema, or due to any intracranial space occupying lesion. On MRI we have found that he is having hemorrhagic venous infarct.  
Alternatively, you can read a little detail about this case on following link;
http://www.emedicine.com/radio/topic105.htm
Hope this helps.
Bye.