Father underwent brain stroke has left side hemiperasis. Is safe for us to bring him home?
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My father underwent a brain stroke in the right-side and it led to left side hemiperasis. Below is the summary of events in the chronological order: Brain Stroke: Nov 20 21:30 IST (approx) Injection Administered : Nov 21 22:40 IST (approx) , well with in 3 hours Injection Details: "Recombinant Tissue Plasminogen Activator"(TNK-t-PA Injection 40 mg)Velix-40Tenecteplase Injection 40 mg, Cost 36k INR MRI Report attached : Nov 21 10:00 IST (aprox) Medications: Attached General Progress: My father experienced acute headache in the initial 4 days and concern was raised by everyone including me. However with added medications and time, headache has subsided to a considerable but tolerable limit. Physical Progress: My father can move his affected left leg little bit but can't raise it against gravity nor can he stand on his own. There is minimal movement observed in the left arm and very little slurring in the speech. Mental State: Although in irritated and agitated state, my Father can still recognize everyone and speak wisely. However he is not yet aware of the exact occurence of events leading to current predicament. Current Status: CT scan was done yesterday evening and is attached too. Physician's Opinion: He is suggesting to take my father home and continue with prescribed medicines as well as physiotherapy. However I need an expert opinion from your side based on the data provided, that is it safe to transfer him home or further medication is needed?
Posted Wed, 18 Dec 2013 in Stroke
Answered by Dr. Praveen K Nath 2 days later
Brief Answer: RT MCA INFARCT Detailed Answer: DEAR MR XXXXXXX HELLO WISHING A SPEEDY RECOVERY TO YOUR FATHER . I have gone through your fathers history , examination & treatment details as per attachments . Your father suffered a stroke with RIGHT MCA infarct. I/v tpa was rightly given . May i suggest you 1. Kindly continue with all prescribed medications viz ANTIPLATELET AGENTS / ANTICONVULSANTS / CITICHOLINE / METHYLCOBALAMIN ETC. 2 SLURRING OF SPEECH & left leg weakness should gradually improve . 3. Continue with regular physiotherapy & speech therapy 4 NO NEED to make him aware of whatever happened in the past . at times this retrograde amnesia for past events helps in maintaining a positive attitude towards life. 5 I would suggest you to get a REPEAT CT SCAN HEAD before discharge , to rule out any hoemorrhagic event . 6 Closely monitor his BLOOD PRESSURE & BLOOD SUGARS ETC. 7 Maintain strict diet control ( low fat low carb diet ) 8 Regular check ups with neurologist every month Thanx Hope this answers your querry Dr XXXXXXX k XXXXXXX Director Deptt. of neurosurgery