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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Can Cause Sudden Stroke Along With Urinary Incontinence And Aphasia?

Just received a call about a patient known to me who has developed sudden onset stroke symptoms 4 days ago, on Saturday, with progressive right hemiplegia, urinary incontinence, dysarthria and aphasia. CT Scan yesterday, shows small hypodensity involving left internal capsule suggestive of old gliotic area. There is no intra-cranial space occupying lesion. Other CT scan features reportedly within normal observations. Currently conscious and fairly agitated. She is HIV treatment experienced with history of being virally unsuppressed and managed currently with an optimized regimen. Treatment details and current HIV treatment response yet to be provided. Patient is yet to be fully assessed at hospital facility. What could be the scenario here?
Mon, 17 Sep 2018
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Neurologist 's  Response
Hi,

The small hypodensity describe does not explain the patient's symptoms, apart from it being described as old, it wouldn't cause aphasia and agitation. So another cause must be searched and she must have an MRI as soon as possible, it is not clear why she's not in a hospital. Regarding the cause, of course, the MRI is needed to say that but given the prior medical history of HIV, an opportunistic infection or a lymphoma would be the first diagnostic hypothesis.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Olsi Taka,
Neurologist
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What Can Cause Sudden Stroke Along With Urinary Incontinence And Aphasia?

Hi, The small hypodensity describe does not explain the patient s symptoms, apart from it being described as old, it wouldn t cause aphasia and agitation. So another cause must be searched and she must have an MRI as soon as possible, it is not clear why she s not in a hospital. Regarding the cause, of course, the MRI is needed to say that but given the prior medical history of HIV, an opportunistic infection or a lymphoma would be the first diagnostic hypothesis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olsi Taka, Neurologist