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Doctor insights on: Stroke Patient

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What % of ischemic MCA stroke patients benefit from tpa (alteplase)?

What % of ischemic MCA stroke patients benefit from tpa (alteplase)?

Depends: This is a complex question. It depends on what percent of is already showing signs of infarction (dead brain) rather than just ischemia (brain at risk).... When we see > 1/3 of territory abnormal on initial ct scan, it is a contraindication for tpa (alteplase). It also depends on how long the symptoms have been occurring. But to answer your question, theoretically all could potentially benefit. ...Read more

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Cerebral stroke, tia, mini stroke--which are preventable?

Cerebral stroke, tia, mini stroke--which are preventable?

All preventable: All of the above are preventable by routine measures such as good blood pressure control, proper diet, exercise and blood sugar control. ...Read more

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66yr/ m congestive heart failure, stroke, pulmonary embolism, then 2nd massive hemorrhagic stroke, surgery to repair, fell into coma. prognosis?

66yr/ m congestive heart failure, stroke, pulmonary embolism, then 2nd massive hemorrhagic stroke, surgery to repair, fell into coma. prognosis?

Guarded: I am sorry for this situation. No one can say for sure what will happen, but from your description, I think the prognosis would be guarded. ...Read more

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Does the cardioemolic stroke patient (otherwise healthy) benefit from statins ?!

Does the cardioemolic stroke patient (otherwise healthy) benefit from statins ?!

Cardioembolic stroke: Good question. Strictly s[peaking, statin should not help cardioembolic stroke. Howevere, statin may help the cause of cardic source of emboli such as ischemic cardiomyopathy. ...Read more

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Why don't stroke patients get tpa (alteplase) therapy?

Why don't stroke patients get tpa (alteplase) therapy?

They can: If having a stroke one can receive intravenous tpa (alteplase) up to 3 hours once symptoms begin and up to 4.5 hours in certain cases. After this intra. ...Read more

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Why does a stroke patient or elderly person lose bowel control?

Why does a stroke patient or elderly person lose bowel control?

Disinhibition: There are various reasons: just as one can be paralyzed and unable to move the muscles of the arm or leg, they may be unable to maintain sphincter control due to muscular weakness. Or they may not be able to feel that they need to evacuate. Or there may be higher cortical disinhibition in which they do socially unacceptable things they would never do if they had their full mental capacity. ...Read more

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Names of most suitable ssri antidepressant needed for multiinfarct stroke dementia patient, 67, with minor congestive heart failure, atrial fibrillation, diabetes. Dosage and duration info appreciated.

SSRIs: There is some evidence that ssris help with post stroke remodeling where the brain works on regrowing connections between brain areas that were not killed by the stroke. There is also evidence they help prevent post stroke depression that is very common. Not much reason to think one ssri is better than another. See your prescriber for specific dosage recommendations. ...Read more

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Elderly lady had stroke due to blood clot. Has brain swelling. In a coma. Stroke induced. Chances of survival?

Elderly lady had stroke due to blood clot. Has brain swelling. In a coma.  Stroke induced. Chances of survival?

Hard to say: The pre-illness health, speed of recognition and early care all play into this status.The physicians at the bedside have a better access to the information needed to answer this question. ...Read more

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Is HBOT therapy advised for stroke patients?

Hyper-baric oxygen: We use for ischemic limbs to prevent amputation, and find some utility in bad infections. Some research has been done in stroke, and occasional acute cases have responded, but oxygen treatment for stroke remains controversial and so far, not in main stream. ...Read more

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Will doctors induce coma for stroke victim?

Will doctors induce coma for stroke victim?

Usually not: There have been studies of barbiturate induced coma and hypothermia in many stroke patients. Outcomes have been mixed or disappointing, and still the best approach is acute t-pa, given in the emergency dept. ...Read more

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What are the stroke survival rates for moderate stroke with brain occlusion?

What are the stroke survival rates for moderate stroke with brain occlusion?

Variable: It is hard to answer your question as survival rates or life expectancy after a "moderate stroke" would depend on the underlying cause, the type of stroke, ie embolic, lacunar, hemorrhagic, and the location of the injury. Adjusting your underlying risk factors for stroke and optimizing your medical care are key to lowering your risk for future stroke. ...Read more

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Warafin clopidogrel aspirin given Hospital patient 89yrs has COPD stroke and heart attack will need limit Vegetables high chance of bleed? Correct?

Warafin clopidogrel aspirin given Hospital patient 89yrs has COPD stroke and heart attack will need limit Vegetables high chance of bleed?
Correct?

Yes : We have to weigh the risk and benefit. It seems like the risk of recurrrnt stroke is high here . Suggest to stop Aspirin . This definitely needs a consultant for decision making ...Read more

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Should brain aneurysm patient have laparoscopic surgery?

Should brain aneurysm patient have laparoscopic surgery?

Depends: While it may be safe, if this is an elective procedure, i would check with your neurologist or neurosurgeon as to precautions that might be prudent. If the blood pressure is controlled, there should be minimal risk. ...Read more

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Is ischemic microvascular brain disease related to stroke?

See comments: Are you referring to radiology reading of an MRI of brain? In elderly, often thought that white matter lesions are associated with "microvascular angiopathy", sign of potential atherosclerosis. Maybe potential stroke risk, especially lacunar infarct, but not straightforwards. Your physician needs to assess stroke risk. Spots more likely from migraine or prior injury. ...Read more

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What's the difference between ischemic stroke, hemorrhagic stroke, and embolic stroke?

What's the difference between ischemic stroke, hemorrhagic stroke, and embolic stroke?

Pathophysiology: Ischemic stroke occurs when an artery to the brain is blocked.A thrombotic stroke occurs when diseased or damaged cerebral arteries become blocked by the formation of a blood clot within the brain. An embolic stroke is also caused by a clot within an artery, but in this case the clot (or emboli) forms somewhere other than in the brain itself. Hemorrhagic stroke is sudden bleed into the brain. ...Read more

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Please describe the mortality rate for stroke victims?

Please describe the mortality rate for stroke victims?

Significant: Stroke is the third leading cause of death in the usa, and the most common cause of long-term disability. Rate of death is highly dependent on size, location, and duration of decreased blood flow, and too many variables to be specific, as each case varies. ...Read more

Dr. Al Hegab Dr. Hegab
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Father, 69, requires Cataract surgery in both eyes. He's on Dabigatran, Clopidogrel for Heart attack, Atrial Fibrillation, Vascular Stroke for 3 years. Had minor strokes in 2008 and 2009. Need advice on cataract surgery while on dabigatran, any risks?

Dr. Al Hegab Dr. Hegab
5 doctors agreed:
Father, 69, requires Cataract surgery in both eyes. He's on Dabigatran, Clopidogrel for Heart attack, Atrial Fibrillation, Vascular Stroke for 3 years. Had minor strokes in 2008 and 2009. Need advice on cataract surgery while on dabigatran, any risks?

Cataract surgery: while on anticoagulation therapy: this is a judgmental call amongst the ophthalmic surgeon and the anaesthesiologist. Generally for surgical procedures or spinal anesthesia, anticoagulaton needs to be discontinued before the surgery, as for Dabigatrean, 1-2 days prior to surgery and resumes after, while the clopedogrel you to hold 5 days prior to elective surgery. Again refer to the treating team ...Read more

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