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64 year old male had a stroke on 18.11.12. Since then he has had 5 strokes. 4 of them were after 9 hours interval whereas the 5th stroke was after 2 hours of the previous one. Each time, for 40 seconds his left arm and leg stop functioning. An MRI has been carried out and it shows clotting in the brain.
Patient had a heart bypass in 2002, also suffers from Sugar and High blood pressure.
CSF EXAMINATION/ DF SHOWS: RESULT NORMAL RANGE
COLOUR COLOURLESS COLOURLESS
TRANSPARENCY CLEAR CLEAR
COAGULUM NIL NIL
C.S.F PROTEIN 109 15-45MG/DL
GLUCOSE 56 50-75MG/DL
CHLORIDE 124 122-132MMOL/L
R.B.C NIL /HPF
W.B.C 06 <05MM3
TYPE OF CELLS MOSTLY LYMPHOCYTES
Looks like an ischemic stroke. Protein levels are raised in the CSF, in inflammatory conditions. Since there is a clot, looks like an ischemic stroke. Ischemic stroke occurs as a result of blockage to an artery. For this therapy with clot dissolving drugs (thrombolytics), should be initiated early. Aspirin, an anti-thrombotic drug, is given immediately after an ischemic stroke to reduce the likelihood of having another stroke. Tissue plasminogen activator (TPA), needs to be given within 4.5 hours after stroke symptoms, this restores the blood supply to the affected part.
The blood pressure and diabetes need to be well controlled. And once his clinical condition is stabilized, a rehabilitation program can be charted out.
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