Page 1 of 1: please help: CVA questions

Amanco · Credits: 205 My Scrapbook

a 58 year old woman was brought to hospital paralysied on the left side of her body. She had a long history of hypertension and her blood pressure on admission was 230/120. she hardly spote to all, but when she did, it was very laboured and with no normal rhythm and tone although the ffew words she did say were meaningful. She was right-handed and the muscles on the right side of her face contracted normally, but those on the left did not. However, she could furrow her brows bilatelrally and close both eyes tightly. Phasic stretch reflexes were increased in the left limbs and Babunski's sign was also present on the left side. Somatosensory tests also revealed marked loss of tactile discrimination and positional and vibratory sense. Loss pf pain perception was less evident.

1) What problem is resposible for the neurological deficits in the patient?

2) What was the most probable site of the lesion in the central nervous system?

3) Could damage to sites outside the internal capsule have produced the same neurological deficits?

4) which blood vessels are likely to be involved?

5) What are the main types (causes) of cerevrovascular accident?

6) Account for the motor dysfunction in the patient?

7) Why could the patient close both her eyes yet not be able to smile normally?

8) What kind of language problem did the patient have?

9) Is the presence of a language problem here unusual?

10 )Why are there visual deficits?

11) why is pain less affected than other sensory modalities?

new_doc · Credits: 5995 My Scrapbook My Reading List 17 Books

1) CVA
2)internal capsule as its a dense hemiplegia
3)not too sure, as it would have to be very wide spread to produce such a picture.
4) right middle cerebral artery
5) thrombotic, embolic, hemorrhage
6)the involvement of the cerebrosplinal tract
7) upper motor involvement of the 7th nerve( the part of the face from the eye above is supplied bilaterally)
8) motor aphasia/dysphasia( not too sure of this one but i thnk its correct)

new_doc · Credits: 5995 My Scrapbook My Reading List 17 Books

actually the involvement of languauge is not unusual as broca's area is supplied by the middle cerebral artery as well.
10) i cant figure out where in the question is the visual deficit

new_doc · Credits: 5995 My Scrapbook My Reading List 17 Books

oops just realised something broca's is suppied by the left middle cerebral artery n the involvement here seems of the right mca, a little confused now so hopefully someone can help out

Amanco · Credits: 205 My Scrapbook

Thank you for your contribution new_doc

dr_noody · Credits: 226 My Scrapbook

Dear Dr

Thanks alot for ur lovely help, i'm pleased u helped me and hope to help me with other cases soon

new_doc · Credits: 5995 My Scrapbook My Reading List 17 Books

u are welcome.

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