Question

A 77-year-old woman was cooking in the kitchen when she collapsed onto the floor. Her daughter called an ambulance and the woman was taken to the emergency room. She had suffered a stroke, and slowly regained consciousness over the next two days. However, when she woke up, she had the following signs and symptoms:

- paralysis of the right face and arm

- loss of sensation to touch on the skin of the right face and arm

- inability to answer questions but ability to understand what was said to her

- ability to write down her thoughts more easily than to speak them

1-What is the name of her language disorder, and what caused it?

2-If there was no increase ICP detected from the test performed at the hospital then what types of strokes could she have possibly had?

3-What could have been some factors that have predisposed this old lady to having a stroke?

4-What are some testing that were done her once she was admitted to the hospital? Why was testing needed before her treatment for her stroke was started?

5-This is a 2 part question:

a) Her test results also spotted several small aneurysms. What is an aneurysm? What would rupture of this cause?

b) Her collapse to the fall also caused a mild blow to her head, with no permanent damage. What kind of head injury would this be?

Answer 1

Answer:

1. Broca's aphasia. It is a language disorder in which patient can understand what the others being said but unable to speak.it is caused by the damages of area in the brain called broca's area, which is present in the frontal lobe, mainly in the left side of the brain, and this part of the brain is responsible for speech production

2. There are three types of stroke, ischemic stroke, hemorrhagic stroke, transient ischemic attack( TIA). Ischemic strock occurs due to the blood clots os fat deposition , it leads to blockage in the artery which supplies blood to the brain.hemorrhagic stroke occurs when the blood vessels in the barin ruptures and bleeds. TIA is due to a temerory blockage or dicreased blood flow to the brain, and the symptoms associated with TIA last only for a short period of time. When hemorrhagic stroke occurs, it can produce an increase in intracranial pressure, but it is absent in this patient. So from the given scenario ,patient could have ischemic stroke.

3. Predisposing factors:

- Age ( old age)

- hypertension

- diabetes

- heart and blood vessel diseases

- high cholesterol

- smoking, alcohol misuse

- obesity

4. Before starting the treatment, patient should undergo for

Radiological inestigation such as,

- CT or MRI brain to identify the type of stroke.

- ECG and Echocardiography to rule out the cardiac cause for stroke.

- carotid dopler/ultrasound, to check for narrowing or blockage in carotid arteries

- cerebral angiography to confirm the blood clot or narrowing in blood vessel of the brain.

Laborotory investigation such as,blood sugar, cholesterol, complete blood count, serum electrolyte,coagulation profile.