Mr. Q, age 64 years, developed a severe headache several hours ago that has not

Question

Mr. Q, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Q has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.
Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma. Explain the predisposing factors in this case, and relate Mr. Q’s initial signs to the pathological changes. Discuss the treatments available after first aid for stroke patients and the patient’s prognosis.
Mr. Q, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Q has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.
Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma. Explain the predisposing factors in this case, and relate Mr. Q’s initial signs to the pathological changes. Discuss the treatments available after first aid for stroke patients and the patient’s prognosis.
Mr. Q, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Q has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.
Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma. Explain the predisposing factors in this case, and relate Mr. Q’s initial signs to the pathological changes. Discuss the treatments available after first aid for stroke patients and the patient’s prognosis.

Explanation / Answer

Thrombus is an abnormal clot which develops in the vessel due to atherosclerosis. Throbi causes pale infarcts. They prevent flow of blood.

A floating clot is called embolus. emboli causes red infarcts. it allows flow of blood and sometimes blood flows out throgh the damaged area.

Atheroma is the buildup of fatty material in the walls of the arteries leading to the narrowing of their walls.

Repeated injuries to the endothelium due to obesity, diabetes, high blood pressure, smoking etc. lead to atheroma. The white blood cells sent to the injured area, which then form foam cells. These attact fats and cholesterol, causing atheroma. The symptoms shown by Mr. Q indicate a stroke.

Treatment:

A medicine to minimise long term effects of stroke should be given within the first four hours of the stroke.

The blood sugar level should be checked.

MRI and CT scan determine the exact nature of the stroke and possible line of treatment includes medication and surgery.

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