Brief Answer:
Lacunar infarct/BP control/Antiplatelets and statins

Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I have gone through your mother's CT report.She is having a lacunar infarct in left ganglio-thalamic region.Probably she had high blood pressure for a long time(may be years) and long term effects of hypertension on small vessels of the brain has resulted in lacunar infarct.
Lacunar infarcts are commonly seen in patients of high blood pressure.

Plan of management-
1)She should be put on antihypertensives(perindopril and indapamide combination).Strict control of blood pressure is vital to prevent further damage to vessels of brain and thus to prevent future strokes.If her blood pressure is not controlled well,she may have recurrent infarcts,in future.
2)She should be put on regular antiplatelet drugs(aspirin) and statins(atorvastatin or rosuvastatin).These medicines should be continued for life unless any contraindication.
3)If she has a weakness in limbs,physiotherapy should be continued.
4)She must be screened for other risk factors like Diabetes and Heart disease.

If you have any further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

---

Brief Answer:
Does she have a limb weakness or facial deviation(asymmetry of face)?

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

I have gone through the prescription.I would surely like to make a comment on it but I need to know a few details beforehand-
1)Did she have a stroke prior to this?
2)Does she have a limb weakness or face deviation with this stroke?

Please follow up with details so that I can guide you further.If possible,please click the image of CT scan and upload.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

---

Brief Answer:
This should be the typical prescription.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

You still did not tell about the past medical history,as I asked for?However,as you did not mention,I assume that she did not have a past history of stroke.

If she would have presented to me as an outpatient in person with this clinical scenario,I would have prescribed the following medications:
1)Tab.Coversyl Plus 1 OD(once a day,early morning)
2)Tab.Ecosprin-AV(150/20) 1 OD(in the evening)
3)Tab.Strocit 1 BD(twice a day) for 3 months

This prescription has got some differences from her current prescription but this is the usual prescription we put on to an infarct patient.

Strict BP monitoring. If BP does not remain controlled on Coversyl Plus,please follow-up as some other antihypertensive medicine will be added then.Target BP should be,not more than,120/80 mm Hg.


PLEASE TAKE ALL MEDICINES UNDER THE GUIDANCE OF A PHYSICIAN ONLY.

If you have any further questions,I shall be glad to answer.


Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

---

Brief Answer:
Prescription is fine.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.

I have gone through the prescription you have uploaded.This seems to be fine except that -coversyl plus should be added and strocit should be continued for a period of 3 months.

However,if you think that cognistar injections/ecosprin/atorva or any of the medicines for that matter,will heal the affected part in 3 days,it is not going to happen-not just here,but nowhere in the universe.She will take her time to be completely normal.The affected part of the brain which is an infarct now,is dead and it will not become live again.Recovery here,means that nearby neurons will adapt to the functions of dead part and over a period of months,she will improve clinically.Besides this,if anyone claims that he can heal the affected brain part,these are false claims.

Hope that I have answered your query.If you have any further questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

---