This query is for my grandmother. She is hospitalized and the doctor is saying some brain stroke. She is in conservative medical management. CT scan and other investigations are done. Sharing the reports here. Please let me know how severe is this? What should be the treatment at present?
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Your grandmother, 85 years old, she is admitted to a local hospital with symptoms of stroke as suggested to you by your doctor. I saw her CT scan which shows minor ischemic changes in her brain (attachment removed to protect patient identity), which means old blood clots which is not that significant at her age. And no need to worry from all the reports, the problem looks minor.
But still, as a neurologist, I wish to know about her BP, sugar level and is she able to speak, eat or walk? If all yes, then continue conservative treatment. I wish to get more clinical details about her.
Thank you so much and appreciate your initial input. During hospitalization, BP was 210, how far I am aware she was BP patient. She did not have any type of blood sugar. She is able to eat in very small quantity but not able to walk. Currently catheterized. I just want to know as doctors there told it is a stroke. But does really CT report say it is a stroke? Or some symptomatic problem was started earlier which might have got ignored. Can this white matter which is ischemic occur suddenly or gradually become worse? Doctors there told anything can happen. So does it really severe and what are the chances of bit recovery?
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This white matter ischemic changes are old (attachment removed to protect patient identity). But it may cause deterioration in the presence of associated clinical conditions associated like very high blood pressure and low sodium, in her case is around 127. But she needs one MRI of the brain and carotid doppler, 2D echo because there is one condition like TIA (transient ischemic attack). In this condition, the CT scan will be normal. So, if possible complete the remaining work up and show it to me. Control her BP and maintain it below 160/90 mmHg initially and after 7 to 10 days below 140/80 mmHg. See from your history and CT scan, it does not look severe and as per my opinion, chances of recovery are good but still, she needs to work up as I suggested you.
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