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MRI shows acute non hemorrhagic infarct. What care should be taken?

Hi, My husband had an acute non haemorrhagic infarct in the posterior limb of the right internal capsule(as per MRI report). The Doppler s effect for carotid arteries, and MRA reports are normal. The Echo-cardio gram reports are also normal. Please suggest what care should be taken in this regard. If he leads a healthy lifestyle which includes restictions in diet and exercise, will everything return to normalcy.
Asked On : Sun, 17 Mar 2013
Answers:  2 Views:  450
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Internal Medicine Specialist 's  Response
Hello !

Its pleasure to answer your query.
As per the MRI report,he has an acute stroke episode.There are many risk factors for stroke including hypertension,atherosclerosis,vasculitic disorders,central nervous system infections,embolic phenomenon and many more.

As ECHO Cardiogram is normal for your patient hence it seems to be acute thrombotic episode involving right middle cerebral artery.

For treatment he needs urgent admission in specialized hospital or stroke unit.Along with nursing care,physiotherapy he needs oral antiplatelet drugs such as aspirin,clopidogrel,ticlopidine,dipyridamol and oral statins such as rosuvastatin/atorvastatin.

If he could have presented within 3 hrs from symptom onset there could have been a option of thrombolysis depending upon size of infarct,age of patient,blood pressure at the time of presentation and other major medical illness or past history of major surgery.This decision of thrombolysis is physician dependent as there is a major risk of bleeding during thrombosis.

As carotids are normal on MRA and Carotid doppler is normal there is no need of any interventions for this.

Adequate control of blood pressure,blood sugar,lipids could help to prevent further episodes of stroke.

Improvement in this episode depends upon the level of conciousness of your patient,degree of weakness in limbs and size of the infarct on MRI. NIHS scale can help in assessment of prognosis and management of your patient.You can take help of treating physician regarding this.

Healthy lifestyle,exercise,diet monitoring of blood pressure and sugar,physiotherapy long term antiplatelet agents and statins can definitely help in improvement.It may take one to two months for maximum improvement.

Hope you have satisfied with the answer.If you need any further information i am always happy to help.

Thank you and wish you a better health.

Answered: Sun, 17 Mar 2013
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General & Family Physician Dr. Mamun Kabir's  Response
Thank you for your query.
I am so sorry to know that your husband suffering a lot.

There are some risk factors for infarction.
The common are diabetes mellitus,high pressure,smoking,hyperlipidemia,old age,family history etc.
Usually prognosis depends on the size & area of the involvement.
Patients condition improves slowly.
Optimum medical,physical & supportive therapy is needed.

Try to correct the risk factor if present.
Avoidance of excessive fatty food,extra salt & smoking is very effective.

I hope the condition will be improving gradually with appropriate therapy.
Take care.
Answered: Sun, 17 Mar 2013
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