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Had A Stroke, Was In Rehab. Experiencing Depression And Hypertension. Had MRI Done. What Does It Indicate?

Posted on Thu, 30 May 2013

Question: my husband had a stroke on 2/25, impression from MRI: acute nonhemorrhagic infarction, mostley in l. middle cerebral artery distribution, but also involving a small portion of l. anterior cerebral artery duistribution. He was in acute rehab for 33 days and discharged with outpatinet pt ot and speech t. His progress contiunes to be good but slow. He is 52, very healthy , non smoker, light drinker, low stress job, hpyertension, being treated since 1/13 with meds. He had some gum surgery 2 weeks prior to stroke. Needlsess to say, we are devestated. We continue with therapy and do an additional 2 hours of thereapy at home daily. He is experiencing depression I can not find a counciler/therapysit that he can talk to that specializes in this. Any suggestions? We are very hopeful that he will have a full or almost full recovery.

Answered by Dr. Sudhir Kumar (2 hours later)

Hi,

Thank you for posting your query.

I can understand your and family's situation after a disabling stroke in your husband at the peak of his career & life.

Depression is common in certain strokes due to location of infarcts (such as frontal lobes). It can also occur due to the fact that due to severe stroke, totally normal people are made disabled and depedent.

As of now, you can start an antidepressant like escitalopram. Until you get a counseler, you can do the counseling yourself. Try to encourage him and tell him all the positive things. Depression would improve over time, as his disability due to stroke improves.

Please continue with PT, OT and speech therapy, as well as medications to ensure a near complete recovery.

I hope it helps. I would be pleased to answer any follow up questions.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (11 hours later)

thank you for your response. My husband is making progress daily. Would you anticipate that he could fully, or almost fully recover? The most frustating part for him is not being able to communicate very well. We are so hopeful that his speech will fully recover. Any thoughts on this? His comprehension is good. He is starting to be able to read, and follow written directions. I.E. multiple choice, circle on word and underline the other. Thanks for any insight into this, I am very optomistic that he will fully recover, I hope I am being realistic.

Thanks for your help.

Answered by Dr. Sudhir Kumar (4 minutes later)

Hi,
Thank you for getting back with more details.

Based on your description, he is already improving and making good progress. So, I also hope that he would recover fully or almost fully.
However, if a part of brain is fully damaged, then some deficits may remain. If you have a copy of his MRI report, it would help us in identifying any damaged part of brain.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (5 minutes later)

I will get email you with what the MRI says, I put most of what the MRI says on the first email, but will get more detail later today. THanks so much for your help.

Answered by Dr. Sudhir Kumar (3 minutes later)

Thank you for getting back.
I noted the findings in the initial email, however, we are mainly looking at any changes on T2W and FLAIR sequence images on MRI (presence of hyperintense lesions, gliosis, etc), which could suggest any damage to the brain.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar