Aa
loss of balance unable to walk
My mother had a stroke a month ago and now has weakness in her left side, She was doing great with therapy and had advance alot, HOWEVER, 3 days ago she suddenly can't walk at all she says she feels her left leg heavy and can't keep herself standing, she had NO blurred vision nor dizziness but has been complaining of nausea. I took her back to the hospital and they did and CT scan, EKG lung Xray and bloodwork, and everything came back normal and they told me it was probably in her head. She still can't walk and is weak, can this really be in her head or maybe they missed something, could it be pressure on a nerve in her spine?, She has always been a very active person which why she was so eager at her therapy and was doing so well.
MEDICAL PROFESSIONAL
There are several issues here:
Why did your mother have a stroke a month ago?
May strokes are called embolic. What this means is that a blood clot forms somewhere such as the carotid artery in the neck, or in the heart. These clots break and travel to the brain where they can form a stroke. If she hand a bland stroke ( from lack of blood flow) doctors will often evaluate the carotids with a duplex scan or the heart with an echocardiogram. In these cases, the stroke is only a symptom of the problems in the neck or the heart. If the problems in the neck and heart are not fixed, the patient can have another stroke.
A CT scan of the head following acute changes in neurological status is only helpful in specific types of strokes where the patient had an acute bleed into the brain. Some call this a hemorrhagic stroke. If she were to have an infarct or bland stroke, a CT scan done early following the stroke will typically be normal. Therefore a positive CT scan of the head is diagnostic, but a negative CT scan DOES NOT rule out a stroke. Given the close proximity of the first stroke, I would be very suspicious of another event.
Why would her symptoms be different? If she had another stroke, a different area of the brain feed by a different blood vessel would be affected. Namely in this case it would be called the motor cortex which is that area of the brain that controls motor function to the leg.
Could it be pressure on her spine? Sure but that is still an emergent situation. If for some reason she developed a fracture or a slipped disk that put pressure on a nerve root leaving the spine or the spinal cord itself, a spine surgeon might operate to take pressure of the nerve root or spinal cord. If the spine cord is involved, this is an emergency. Both of these possibilities could be evaluated with an MRI of the spine, and there are some additional specialized test available.
An “in your head” diagnosis is always one of exclusion and only made after a very detailed and exhaustive search for other organic causes.
Why did your mother have a stroke a month ago?
May strokes are called embolic. What this means is that a blood clot forms somewhere such as the carotid artery in the neck, or in the heart. These clots break and travel to the brain where they can form a stroke. If she hand a bland stroke ( from lack of blood flow) doctors will often evaluate the carotids with a duplex scan or the heart with an echocardiogram. In these cases, the stroke is only a symptom of the problems in the neck or the heart. If the problems in the neck and heart are not fixed, the patient can have another stroke.
A CT scan of the head following acute changes in neurological status is only helpful in specific types of strokes where the patient had an acute bleed into the brain. Some call this a hemorrhagic stroke. If she were to have an infarct or bland stroke, a CT scan done early following the stroke will typically be normal. Therefore a positive CT scan of the head is diagnostic, but a negative CT scan DOES NOT rule out a stroke. Given the close proximity of the first stroke, I would be very suspicious of another event.
Why would her symptoms be different? If she had another stroke, a different area of the brain feed by a different blood vessel would be affected. Namely in this case it would be called the motor cortex which is that area of the brain that controls motor function to the leg.
Could it be pressure on her spine? Sure but that is still an emergent situation. If for some reason she developed a fracture or a slipped disk that put pressure on a nerve root leaving the spine or the spinal cord itself, a spine surgeon might operate to take pressure of the nerve root or spinal cord. If the spine cord is involved, this is an emergency. Both of these possibilities could be evaluated with an MRI of the spine, and there are some additional specialized test available.
An “in your head” diagnosis is always one of exclusion and only made after a very detailed and exhaustive search for other organic causes.
Thank you for your reply!, yesterday I finally had her admitted to the hospital after another doctor was suspicious as I was. What we were told is that she seems to have had another episode in the same area as the earlier stroke, which is why the CT scan didn't show anything. However, Im hoping they cant tell me what caused it and could it happen again. Thank you again for you reply, I knew she could be making it up.
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