An interrupted blood supply to the brain due to a blocked vessel causes the brain cells to die, leading to a medical emergency called a stroke. They can be due to ischemia or hemorrhage. In an ischemic stroke, the blood supply is altered due to a blocked artery. The ischemia can also be due to narrowing arteries in atherosclerosis. Transient ischemic stroke or mini-stroke occurs due to a brief interruption of blood supply. It is not as serious as a stroke but is an indication of the risk of future stroke. Symptoms include one-sided numbness and weakness, blurry vision, slurred speech, confusion, dizziness, altered gait, imbalance, and headache. Blood thinners are used to dissolve the blood clots while they are forming. Hence an immediate treatment is necessitated to prevent further complications.
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Which anticoagulant is best to prevent stroke- Apixaban or Dabigatran?
Query: Hello doctor,My mom has had an ischemic stroke. She is currently taking Warfarin, Bisoprolol, Ramipril, and Furosemide. Despite the Warfarin at 5 mg, her INR is 1.7 (which is outside the therapeutic range). She is 90 lbs and age is 76. She is being encouraged by her doctor to change the anticoagulan... Read Full »
Answer: Hello,Welcome to icliniq.com.As per the history, it looks like it is getting difficult to manage with Warfarin. Warfarin is notorious in terms of interacting with many other drugs and thereby it is difficult to achieve the target therapeutic level. So, now newer oral anticoagulants are used with no ... Read Full »
How to prevent clots and blockages after an ischemic stroke?
Query: Hello doctor,My 71-year-old mother got a couple of ischemic strokes nearly two months ago. She was then given strong blood thinning injection, which led to a couple of blood vomits and a hemorrhage as well. During the hospitalization as well as afterward, she has been taking Pradaxa 110, etc. (presc... Read Full »
Answer: Hello, Welcome to icliniq.com. I have gone through the files attached (the attachment was removed to protect the patient's identity). The clots which are found at so many places in the body are basically originating from the heart and being thrown into the body as she is post-MVR (mitral valve reg... Read Full »
What does it mean to have a sudden onset of slurred speech?
Query: Hi doctor, My 70 year old father has developed slurred speech from two days. He has diabetes, benign prostate hypertrophy, and history of vascular dementia. He does not have weakness, paralysis, or numbness. He does not have hypertension or any cardiac disease. He refused to do a CT scan in the ER.... Read Full »
Answer: Hello, Welcome to icliniq.com. In a patient, having risk factors, like diabetes mellitus and acute onset slurring of speech, it raises the possibility of developing an acute stroke. Though there may be other causes too. I would suggest undergoing the following tests: MRI of the brain or N... Read Full »
What does my CT scan indicate?
Query: Hello doctor, My CT scan impression is as follows: hypodensity seen in right external capsule - infarct. Diffuse cerebral atrophy. Lacunar infarcts in bilateral basal ganglia, corona radiata and centrum semiovale. What does this mean? Please help. Read Full »
Answer: Hello, Welcome to icliniq.com. Regarding your concern, I would explain that these CT (computed tomography) scan findings indicate repeated small ischemic strokes related to uncontrolled high blood pressure. I would recommend performing a Doppler ultrasound of the carotid arteries to exclude any po... Read Full »
CALR Exon 9 mutation is detected. Do I have to worry?
Query: Hello doctor, I am a 46-year-old male. A month ago, I had a heart stroke and underwent angio for blood clotting thrombus. My CBC report at that time shows a platelet count at 24 lakhs. I received CALR Exon 9 mutation analysis report today. It reads "CALR Exon 9 mutation is detected by PCR amplificat... Read Full »
Answer: Hello, Welcome to icliniq.com. You have very high levels of platelets which are called 'primary thrombocytosis' or 'essential thrombocytosis', which was confirmed by CALR Gene mutation test. This condition will results in either clots or sometimes bleeding in any part of the body. There are few t... Read Full »
Can reactive thrombocytosis cause stroke?
Query: Hello doctor, I donated plasma through plasmapheresis. When the IV was initially inserted, my blood did not flow through the machine. The technician came by and wiggled the IV, but the blood still did not flow. The technician then switched the IV to my other arm. It began to flow after about five mi... Read Full »
Answer: Hello, Welcome to icliniq.com. It is very rare for reactive thrombocytosis to cause a stroke. It may happen if you have other risk factors for stroke like hypertension and high cholesterol. However, I am hoping that they have ruled out other causes of thrombocytosis (increased platelet co... Read Full »
My mother is throwing up every time she has Metformin. What is the correct dosage for that?
Query: Hi doctor, My mom had three strokes five days ago. While in the hospital, they said that she has diabetes, plagues in her artery, and some damage in her liver from taking too much Aleve (Naproxen). She is home now, and they advised her to take Amlodipine Besylate 10 mg, Atorvastatin 80 mg, Clopidog... Read Full »
Answer: Hi, Welcome back to icliniq.com. Please share her reports for stroke episodes. Are you talking of myocardial infarction (MI) with coronary artery blockage or a neurological stroke comprising ischemia in the brain due to cerebrovascular-related blockage? It appears that the medicines she is presc... Read Full »
I fell twice with high BP. Am I at risk of having a stroke?
Query: Hi doctor, I had a stroke two weeks ago. Today morning, when I got up off the table, I nearly fell twice and had trouble speaking. My BP was 220/110 mmHg. They took me to ER and the telemetry unit. I got an MRI with contrast this morning. Am I having a stroke? Read Full »
Answer: Hi, Welcome to icliniq.com. I read your query with keen interest and understand your concerns. The onset of problems in the early morning, blood pressure in a range which can cause stroke and difficulty in speaking along with two falls point towards the high possibility of stroke. The ... Read Full »
What is the survival rate of a person with ischemic brain disease?
Query: Hello doctor, My neurologist has told me that I have a moderately severe ischaemic brain disease. What can I do apart from taking medication to control the blood pressure and cholesterol? I experience many different symptoms, including constant head pressure, especially when I feel distressed, weak... Read Full »
Answer: Hello, Welcome to icliniq.com. According to your statement, you have been suffering from an ischemic stroke. Ischemic stroke is better than hemorrhagic stroke. The hemorrhagic stroke becomes rapidly worsen or better quickly. But ischemic stroke takes time to improve, but the outcome is better... Read Full »
How to manage blood clots in the brain?
Query: Hi doctor, Three months back, my father had a problem in balance, always even while sleeping. We consulted a doctor, and he asked for BMD, where he diagnosed a problem in the bones of the neck and back. A few days back, suddenly, while morning walk, the right leg turned numb, and my father could no... Read Full »
Answer: Hi, Welcome to icliniq.com. I feel sorry for all the pain your father is going through. 1) As from your history I come to a conclusion that you father had TIA (a type of stroke, that is temporary obstruction to the blood flow to a specific part of brain). MRI (magnetic resonance imaging) brain (s... Read Full »