Doctor insights on:
Acute Pontine Stroke
Superficial left pontine tegmentum tiny 3 mm t2 hyperintensity in keeping with a perivascular space on mri. Could this be from a stroke?
Stroke: Not to worry. Perivascular spaces (Virchow-Robin spaces) are normal and not caused by a stroke. They can occur throughout the brain. The perivascular spaces vary in size (up to 5 mm) and are associated with arteries in the brain. ...Read more
4 months post pontine stroke in a previously healthy 44yr old male. Orgasm causes severe neck pain, nausea and dizziness lasting 2-4 hours.
Worrisome: So the stroke victim is apparently not you. Something about this case smells to me like the stroke was due to a top-of-the-basilar occlusion or basilar artery dissection or both. My advice is to lay off the whoopee pending a thorough reassessment by a neurologist including possibly repeat imaging studies viz. MRI and MRA. ...Read more
Pontine stroke: Most of the oedema should now be resolved ...Read more
My husband suffered from brain stroke in pons area one and a half year back. He is recovering but is unable to walk as his left side is still weak.
Very unlikely: It has been reported that acute stress can cause severely elevated blood pressure and thus brain hemorrhage. It is however, very rare. Probably more likely to happen in older patients when the blood vessels are already somewhat damaged. It is another reason to live our lives with less stresses. ...Read more
Acute stroke Rx:
There are many treatments for acute stroke, including:
1. blood pressure management, when needed
2. blood sugar mgmt when needed
3. IV TPA- tissue plasminogen activator, for many cases
5. arterial TPA, (alteplase) in select cases
6. thrombosis retrieval, in very select cases
7. later on, cholesterol treatment, anticoagulation for atrial fib, and artery repair may be options ...Read more
Time is essential: It is most important to seek treatment for sudden changes in the ability to move, sense, or think. If a stroke is treated in first few hours, a great improvement in outcome may be possible. If you wait even a few hours to see if if gets better, the chances of improved recovery are greatly lessened. ...Read more
Depends: Depends on how much you give. If you give 30-40 ml/hr not so much but if its more it might again fuida should be determined by other status as well like renal failure, eating status and many more factors. ...Read more
Could someone regain speech and mobility after a acute stroke with having uncontrollable movements?
Possible: After a stroke the areas around the stroke that are not affected start taking over for the lost function. This leads to different levels of recovery depending on the size and location of the stroke. A good rehabilitation program can expedite and maximize recovery. ...Read more
Please tell me, could some regain speech and mobility after a acute stroke with having uncontrollable movements?
Rehabilitation: Although stroke recovery may be variable from patient to patient, speech and physical therapies offer great promise of recovery, and it is possible to witness dramatic improvements. ...Read more
What exactly is an inflammatory stroke? Neuro said LP can tell us if that's the cause of sudden onset dementia
Possibly: A transient ischemic attack (TIA) is caused by the transient blockage of a blood vessel in the brain, which causes symptoms (weakness, numbness, changes in vision, difficulty speaking, etc.) because the nerve cells aren't working when the blood vessel is blocked. If the blockage is brief (< 1 hour) there may be no damage. If the blockage lasts longer, damage (a stroke) may occur. ...Read more
Yes: Yes indeed. When neurologic symptoms start suddenly we always considered it an acute stroke. If they pass within few minutes or hours completely, they get labeled tia. If they stay and there are changes on mri, then we call it a stroke. But for all practical purposes, TIA is considered an acute stroke at the onset. ...Read more
Doc I had a acute stroke on 9/29/2017 my neurology said we was going to treat it as a warning. I am a truck driver. Is it to soon 4 work?
Question; was it determined what the cause was? Have all symptoms and signs resolved? Is there residual left that would interfere with work??
Certainly, if the stroke is treated correctly and risk factors for recurrence are reduced and your are able it seems reasonable to return to work after 7 weeks. ...Read more
What to do if brain findings are most consistent with a sub acute stroke within the left pica distribution." and what follows this revelation?
Uncover cause: All strokes are caused by vascular compromise, and often due to hypertension or diabetic affects on brain circulation. If you have had a stroke, get it treated, but biggest issue involves preventing future events. Multiple meds are very helpful. See a neurologist who focuses in area of stroke and get stabilized/. ...Read more
Can be improved: Speech therapists help immensely, and are very successful with dysarthria. Occupational therapists may provide additional support. Some medications, such as Ritalin (methylphenidate) may improve dysphasia, and occasionally help dysarthria. So, lots of support out there. Get involved in a rehab program. ...Read more
Time critical: Within 3 hours of symptoms (up to 4.4 hours in some cases) intravenous tpa (alteplase). After that up to 6 hours, intraarterial tpa (alteplase) through a catheter in the artery to the brain. Up to 8 hours can use special devices to pull clot out of vessel to brain. These procedures usually done at stroke centers. ...Read more
No: You can but only under MD supervision ...Read more
Yes: If ct of brain reveal no bleeding and if the pt. Is in the window period (less than 4.5 hours from symptoms)to receive fibrinolytics (tpa (alteplase) or others) this is going to break the clot and restore the circulation avoiding serious neurological damage. Aspirin is started 24. Hrs later after tombolytics. For DVT prevent. Anticoagulants should be used except when hemorrhagic transformation is present. ...Read more
What is included in an assessment of a geriatric patient who has possibly experienced an acute ischemic stroke?
Stroke: A thorough stroke assessment will include medical imaging to include brain, carotid and heart in trying to understand the mechanism of the stroke, chronic conditions assessment and risk factors modification. Physical and occupational therapy, speech and swallow evaluation are also completed and a possible recommendation for short term rehab may be made. Treatment is mostly supportive otherwise. ...Read more
If an MRI shows infarcts as well as periventricular ischemic changes does this mean a person has had an actual stroke rather than just a tia?
Brother had very bad headache and then a sudden onset of weakness on right side of body only arm is still weak now. Stroke? Will not go to doc.
Sounds bad: He needs to go to doc asap! ...Read more
MRI showed damage consistent with stroke but only symptoms is sudden onset delirium not UTI docs unsure if it is stroke4 day delay doing MRI opinions?
Cause of delirium: Certainly a UTI can cause delirium -as the infection throws off the body's balance. A stroke too could cause altered mental status, depending on what part of the brain was affected and whatever other metabolic effects might be going on in that dramatic disease presentation. MRIs are extremely sensitive for stroke. Urine tests are good but have to be interpreted correctly. Try a second opinion here ...Read more
My mother had a surgery for acute subdural hematoma. She suffered stroke years ago. How do I care for her now after this surgery?
Additive effects: An acute subdural hematoma is a form of a stroke and for the purpose of recovery you might want to think of it as one. Did the previous stroke and the hematoma now affect different areas of the brain or roughly the same. Depending on that and on which areas were affected (speech/language/motor) the recovery may depend on this and also the severity of the stroke and the hematoma. ...Read more
28y man. Hi stress job. Hx mini stroke >4y ago. Anxiety episodes Recent onset-sharp pins/needles feeling in heart, wkness, s/b. lasted >30s. Thoughts?
Generalized anxiety: Or panic disorder, but these symptoms and clinical correlation with the setting certainly sound like that may be the case. If you continue having palpitations and sweats, the best way is to see a healthcare provider to rule out organic disease. Once you are determined not to have actual heart or lung disease, or infection, then you will need a psychiatrist to help manage stress/anxiety. ...Read more
My mother is suffering from acute ischemic stroke, she is diabetic, her late arrival to the hospital made situation bad since none of the initial tissue activator were given to her. How can I manage her health situation?
You can't on ur own: First, I am sorry for what happened to your mother, and wish her recovery and health. Second, this a complex health situation, a team approach of physicians, nurses, physical therapist, rehab specialists, helpers, social workers would all act together, your part would be to coordinate her care being a loving and caring son, hope all or part of those facilities are available for your mother, ...Read more