List the primary diagnosis and rational
The primary diagnosis for this patient would be is a Right-sided ischemic stroke. Ischemic stroke is an acute
... [Show More] neurologic deficit lasting less than 24 hours and caused by cerebrovascular etiology (Bamford, Sandercock & Dennis, 2001). It can be subdivided into an ischemic stroke that is caused by a vascular occlusion, or hemorrhagic stroke caused by a vascular rupture. Stroke is the third leading cause of death and a major cause of disability on the US, and ischemic strokes account for 87% of all stroke cases.
Ischemic stoke is more common in African American’s and Hispanic’s (Chambers & Norris, 2006).
List THREE differential diagnosis with a rational for the case study you are assigned
Describe the pertinent history required to make the diagnosis
Describe your physical exam findings you anticipate seeing for this diagnosis
Discuss the treatment plan for the patient in your case study using this format
Without cerebral venous sinus thrombosis:
Presentation within 4.5 hours:
Presentation after 4.5 hours:
With cerebral venous sinus thrombosis:
Education/Interventions/ lifestyle changes:
Referrals:
o Nutritionist- To help build a low-fat high grain diet program
o Physical Therapy- To help with any extremities deficit from stroke, and to help build an exercise program.
o Lab- Go get lab work of CBC, CMP, A1c, and TSH
Follow up:
o Follow up with primary care provider on lab work and better management of blood pressure, and blood sugar.
o Go directly to ER if dizzy, light headed, severe headache, confusion, trouble speaking, numbness or weakness, trouble seeing, or trouble walking.
References
Bamford J, Sandercock P, Dennis M. (2001). Classification and natural history of clinically identical subtypes f cerebral infarction. Lancet Jun 22;337(8756):1521-6
Chambers BR, Norris JW. (2006). Outcome in patients with asymptomatic neck bruits. N Engl J Med. Oct 2; 315(14): 860-5.
Easton JD, Saver JL, Albers GW. (2009). Definition and evaluation of transient ischemic attack. Stroke; 40: 2276-2293.
Harper C, Fornes P, Duyckaerts C. (2005). An internatl perspective on the prevalence of the Wernicke- Korsakoff syndrome. Metab Brain Dis. Mar;10(1):17-24.
Kidwell CS, Alger JR, Di Salle F. (2009). Diffusion MRI in patients with transient ischemic attacks, Stroke. Jun;30(6):1174-80
Smith EE, Rosand J, Greenberg SM, (2005). Hemorrhagic stroke. Neuroimaging Clin N A. May; 15(2): 259- 72.
Qureshi Al, Tuhrim S, Broderick JP. (2001). Spontaneous intracerebral hemorrhage. N Engl J Med. May 10; 344(19): 1450-60. [Show Less]