Response to Christine

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Neurological disorders can be complex in diagnosing and treating; however, it is vital to analyze and make early accurate identification of disease conditions so that prompt treatment and management can be done in emergent situations. Hence, it is crucial to analyze all presenting signs, symptoms, history critically, and physical assessment findings to ensure appropriate focused care is provided.

 

Case Study 3

A 50-year-old African American male presents with complaints of dizziness left arm weakness and fatigue. PMH: poorly controlled diabetes, hypertension, hyperlipidemia PE: Upon exam, you noted very mild dysarthria, he understands and follows commands very well. Mild weakness on the left side of the face is noted and left-sided homonymous hemianopsia but no ptosis or nystagmus or uvula deviation.

 

Stroke

An interruption in the brain’s continuous blood flow.  According to Boehme et al. (2017), stroke is the leading cause of long-term adult disability and the fifth leading cause of death in the US, with approximately 795,000 stroke events in the US each year. The majority (approximately 80%) of strokes are ischemic; although the relative burden of hemorrhagic versus ischemic stroke varies among different populations, hemorrhagic strokes can be either primarily intraparenchymal or subarachnoid. Ischemic stroke can be further divided into what has been referred to as etiologic subtypes, or categories thought to represent the causes of the stroke: cardioembolic, atherosclerotic, lacunar, other specific causes (dissections, vasculitis, specific genetic disorders, others), and strokes of unknown cause; symptoms include, numbness or weakness of the face, arm, or leg, especially on one side of the body, confusion, trouble speaking or understanding • loss of vision or difficulty seeing in one or both eyes sudden, difficulty walking, dizziness, loss of balance or coordination, unusually severe headache with no known cause (Boehme et al., 2017).

Boehme et al., also emphasize that reducing the burden of stroke in the population requires identification of modifiable risk factors and demonstration of the efficacy of risk reduction efforts. There are numerous risk factors for stroke, including both modifiable (e.g., diet, comorbid conditions) and non-modifiable risk factors (e.g., age, race). In addition, risk factors may also be thought of as short-term risks or triggers (e.g., infectious events, sepsis, stress), intermediate-term risk factors (e.g., hypertension, hyperlipidemia), and long-term risk factors for stroke (e.g., sex, race). Risk factors for stroke in the young also likely differ from those in older patients; while much is known about long-term stroke risk factors, such as hypertension, diabetes, and atherosclerotic disease, much less is known about short-term risk factors, or triggers, for Stroke (Boehme et al., 2017). In general, stroke is a disease of aging, and the modifiable risk factors are of utmost importance, as intervention strategies aimed at reducing these factors can subsequently reduce the risk of stroke. Additionally, modifiable risk factors can be further divided into medical conditions and behavioral risk factors; the role of many “traditional”” risk factors in causing stroke