Cerebral Vasculature - Clinical Case Flashcards
Mr C.W aged 64 hit a patch of ice on his bicycle and fell off. He was probably knocked out for a second or two, in that he couldn’t remember the moment of impact with the road. He came to his senses lying on the road and a passer-by helped him to his feet.
He had bruised the left side of his head and he had a headache that, over the next few days, became more intrusive.
Five days after the accident he began to notice weakness of his right arm and leg, and his speech became hesitant. By the time his relatives brought him to hospital, 7 days after the accident, he was drowsy, mute and had profound weakness of the right arm.
Examine the CT scans provided, identify any abnormalities that are present and suggest a diagnosis.
Subdural Internal Haemorrhage Stroke:
* Darker areas bcs of haemorrhage
* No sulci and gyri on left hand side bcs extended
* Asymmetry in the ventricles
Mr C.W aged 64 hit a patch of ice on his bicycle and fell off. He was probably knocked out for a second or two, in that he couldn’t remember the moment of impact with the road. He came to his senses lying on the road and a passer-by helped him to his feet.
He had bruised the left side of his head and he had a headache that, over the next few days, became more intrusive.
Five days after the accident he began to notice weakness of his right arm and leg, and his speech became hesitant. By the time his relatives brought him to hospital, 7 days after the accident, he was drowsy, mute and had profound weakness of the right arm.
How do the symptoms seen in the patient relate to the brain pathology identified on the scans?
- Headache bcs of high intercranal pressure
- Weakness of the right hand and leg because of left haemorrhage compressing the nerve
- Pressure on Brocha’s area (expressive aphasia)
Mr C.W aged 64 hit a patch of ice on his bicycle and fell off. He was probably knocked out for a second or two, in that he couldn’t remember the moment of impact with the road. He came to his senses lying on the road and a passer-by helped him to his feet.
He had bruised the left side of his head and he had a headache that, over the next few days, became more intrusive.
Five days after the accident he began to notice weakness of his right arm and leg, and his speech became hesitant. By the time his relatives brought him to hospital, 7 days after the accident, he was drowsy, mute and had profound weakness of the right arm.
What treatment/intervention is required?
Surgical intervention
Mrs I.R aged 54 had suffered from hypertension (elevated blood pressure) for many years. She was on medication to lower her blood pressure but often forgot to take it, and rarely consulted her GP to have it reviewed.
Recently she was hosting a dinner party, when she suddenly complained of headache and promptly fell to the floor, apparently unconscious for a few moments. Her friends called for an ambulance, which arrived within 10 minutes. By that time she had come round but she was drowsy and her speech was slurred. She vomited several times. Over the next few days she gradually woke up but she continued to complain of symptoms of dizziness and clumsiness
She looked as if she were drunk with slurred speech, wobbly eye movements, clumsy hands, and a broad-based hesitant gait.
Examine the CT scans provided, identify any abnormalities that are present and suggest a diagnosis.
Stroke caused by a Lession in the Cerebellum (White staff on the right hand side)
Mrs I.R aged 54 had suffered from hypertension (elevated blood pressure) for many years. She was on medication to lower her blood pressure but often forgot to take it, and rarely consulted her GP to have it reviewed.
Recently she was hosting a dinner party, when she suddenly complained of headache and promptly fell to the floor, apparently unconscious for a few moments. Her friends called for an ambulance, which arrived within 10 minutes. By that time she had come round but she was drowsy and her speech was slurred. She vomited several times. Over the next few days she gradually woke up but she continued to complain of symptoms of dizziness and clumsiness
She looked as if she were drunk with slurred speech, wobbly eye movements, clumsy hands, and a broad-based hesitant gait.
How do the symptoms seen in the patient relate to the brain pathology identified on the scans?
Function of Cerebellum:
* Dysarthria
* Loss of normal reflexes
* Clumsy hand
* Loss of balance
* Cerebellar Ataxia
Mrs I.R aged 54 had suffered from hypertension (elevated blood pressure) for many years. She was on medication to lower her blood pressure but often forgot to take it, and rarely consulted her GP to have it reviewed.
Recently she was hosting a dinner party, when she suddenly complained of headache and promptly fell to the floor, apparently unconscious for a few moments. Her friends called for an ambulance, which arrived within 10 minutes. By that time she had come round but she was drowsy and her speech was slurred. She vomited several times. Over the next few days she gradually woke up but she continued to complain of symptoms of dizziness and clumsiness
She looked as if she were drunk with slurred speech, wobbly eye movements, clumsy hands, and a broad-based hesitant gait.
What treatment/intervention is required?
Medication to decrease hypertension
