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Neurologist Advice [T2 DM + Ischemic stroke (Rt striatocapsular stroke)]

Lalkumar Patel- Male- 56 Year (17/07/1960) – Pharmacy Assistant
Dt. 20/11/2016
Paralysis on face, imbalancing, weakness
Hospitalized: ( 20/11/2016 to 21/11/2016 )-1 Day
BP: 130/80 , Wt: 70.3 Kg
Dr Biren Nayak M.D (Med) Advice:
1. MRI Brain:
• The MR finding show acute in right capsule-ganglionic & centrum semi ovale region.
• Chronic Small vessel ischemic changes in bilateral fronto-parietal white matter.
• Mild cerebral Atrophy.
2. Doppler:
• Calcified & non calcified atheromatous plaques are seen in both carotid bulbs with appr.60-70% luminal narrowing in right carotid bulb & appr.70-80%   luminal narrowing in left carotid bulb.
• RT CCA: 0.8 mm   LT CCA: 0.8mm
• Normal velocity antegrade flow is seen in right vertebral artery. Left vertebral artery appears small in caliber & show no e/o significant colour flow in it.
(Adv: RFT & CT/MR angiography of carotid & cerebral arteries.)
3. 2D Echo:
• MILD LVH, LVEF 60%,   RA & RV Normal, IAS & IVS Intact, E<A Trivial MR.
• Normal LV size & normal LV systolic function.
• Grade l diastolic dysfunction
• No clot in LV, No vegetations, No coarctation of aorta.
4. Sugar Estimation:
• RBS: 375.9  (Dt:20/11/2016)
• Fasting:  Blood sugar-177 & Urine sugar- Nil (Dt.26/11/2016)
• PPBS: Blood sugar-280 & Urine sugar- (++++)(Dt.26/11/2016)

5. SGPT(ALT): 76.9^ & serum Sodium (Na): 134.0


• Ecosprin CV Gold (150/75/20)(0-0-1)
• Gluformin 1 mg (0-0-1)
        1 Month
• Physiotherapy
• Adv. Carotid Angiography  

Dt: 29/11/2016
Consulting Neurologist
Dr Shuchit Pandey – MD.DM (Neurology)
Paralysis on face, Imbalancing, Weakness
Mood swing

T2 DM + Ischemic stroke (Rt  striatocapsular stroke)


 USG(Abd , Pelvis)
 S.Lipid
 S.Vit B12: 897 - N
 HbA1C
 S.Homocysteine : 8.76 –N
 MR Angiography of Brain :
• Right Cerebral peduncle acute infarct & right basal ganglia acute infract.
• Mild Cerebral  atrophy.
• Atheromatous changes in P2 segment of right PCA.
As compared to previous MRI dated 20.11.2016 there is appearance of fresh acute lesion in right cerebral peduncle.
Tab Ecosprin CV Gold (0-0-1)
Nuhehz (1-0-0)
For 2 Month

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