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Had a pacemaker installed. Having stroke symptoms. CT scan showed negative. Prognosis?

Nov 2013
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My brother is in the hospital and has many symptoms of a stroke. The CT scan shows negative. The Neurologist was so mean to him and told him he was faking. He has had 17 episodes and list bladder control, left sided weakness and balance. Because he has a pacemaker they cannot do a MRI... What should we do?
Posted Wed, 24 Apr 2013 in Stroke
Answered by Dr. Sudhir Kumar 51 minutes later

Thank you for posting your query.

The diagnosis of stroke is a clinical one, and the most important role of CT scan is to exclude a bleed (hemorrhagic stroke). The normal CT in your brother has excluded a bleed.

At this stage, the main treatment is to start antiplatelets such as aspirin.

Another aspect is to screen for the likely risk factors for stroke such as high BP, high sugar, high cholesterol and high homocysteine. In addition, the heart should be screened for any clots or atrial fibrillation. If heart is found to be the source of brain stroke, then heparin injections would be necessary.

CT angiogram may be done to exclude any blockage in brain blood vessels, when an interventional procedure may be required if a stenosis of a blood vessel is noted.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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