Study of a stroke patient The National Hospital for 中风患者的国立医院的案例研究课件.ppt

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Study of a stroke patient The National Hospital for 中风患者的国立医院的案例研究课件.ppt

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Study of a stroke patient The National Hospital for 中风患者的国立医院的案例研究课件

Case Study of a stroke patient. The National Hospital for Neuroscience and Neurosurgery By Sarah Hart U0604985 Learning Objectives Introduce the patient and their presenting condition. Explain what a stroke is signs and symptom in this case with particular reference to the Pontine and Reticulospinal tracts. Explain the initial assessment and goals set by the MDT team for the patient History andPresenting Condition Patient is a 72yr old gentlemen. BIBA LAS to UCLH 14/7/08 with slurred speech, reduced power in left arm and leg, after being found on the floor at 1pm that afternoon in his hotel. O/E- pt was found to have Dysarthria, Right Upper Motor Neurone facial palsy, hypoglossal nerve palsy, Left hemiplegia, confusion, and global hyper-reflexia Past Medical History Previous IHD Hypothyroidism Cataracts Chronic Renal Impairments New medical problems that have come to light since admission:- Hyper cholesterol And on MRI- Old R posterior cerebral territory infarct. Further information Social history Until fours years ago was living with parents in a council house, after the patient parent died the patient moved into a hotel. Previous mobilising independently Relied on staff at hotel for domestic duties. Drug history Aspirin Since admission- Simvastatin Levothyroxine Cerebral vascular accident (CVA) Definition- By the WHO as ‘rapidly developing clinical signs of focal cerebral function with symptoms lasting more than 24hrs or leading to death, with no apparent cause other than the vascular origin’ (Smith 1997) Pontine Reticulospinal Tract Descending motor pathways that originate in the pontine and medullary reticular formation and project to medial ventral horn neurons. These pathways are involved in modulating postural adjustments and gait-related movements. Key aspects to a successful rehabilitation for Strokes Based on the “National Service Framework for Long-term Conditions. DoH 05 Prevention Acute management Rehabilitation Transfer to the community Lon