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Habiburrah - Sequelae of stoke (Afghanistan) Posted on October 11, 2013

Author Julia Views Posted at 2014/01/14

Name: Habiburrah

Sex: Male

Country: Afghanistan

Age: 51 years

Diagnoses: 1. Sequelae of cerebral infarction 2. Hypertension 3 level very high risk

Admission Date: 2013-09-06

Days Admitted to the Hospital: 25

Before treatment:

Habiburrah is a 51-year-old male. Two and a half years ago, the patient suffered from emergent motor dysfunction of the left limbs. There was no dizziness, headache, nausea or vomiting. There was also no dizziness when he saw things . His mind was alert. He went to local hospital for treatment, the Bp: 200/110mmHg. The CT examination showed massive brain infarction. Doppler ultrasonography showed right internal carotid artery thrombosis. He received a related examination. About 1 week later, the patient could walk by himself. He insisted on rehabilitation from then to now. Before the treatment, the patient had stiffness of the left limbs. The muscle tone of the left limb was high. The left hand could not raise more than 20 centimetres. The left hand couldn't grasp. The left dorsum pedis couldn't move upward or downward. There was no speech disorder or swallowing difficulty. He could walk with a walking stick. He could wash, eat and take a shower by himself.

Admission PE:

Bp: 139/74mmHg; Hr: 54/min. He had a hemiplegic gait. The respiratory sounds in both lungs were clear, with no dry or moist rales. The cardiac rhythm was regular, with no obvious murmur in the valves. The liver and spleen were not palpable. There was no edema in either lower limb.

Nervous System Examination:

Habiburrah was alert, and in good spirits. He had a sensitive response. The examination of memory, calculation and orientation were almost normal. He had strong muscles to close the eyes. Both pupils were equally round, the diameter was about 3.0mm. Both eyeballs were sensitive to light stimulus. Both eyeballs' movement to each side was almost normal through loose measurement. There was no nystagmus. He had strong chewing muscles. The tongue was almost in the center of the oral cavity. The teeth were shown without any shifting. The uvula was almost in the center. The muscle strength for turning the neck was strong and symmetrical. His right side had strong muscles to shrug the shoulder, but the left side was weak for shrugging the shoulder. The left shoulder drooped. There was obvious muscle atrophy in the deltoid. The muscle strength of the left upper limb's near end was level 3 and the far-end was level 2. The muscle strength of the fingers of the left hand was level 0. The muscle strength of the left lower limb's near-end was level 4- and the far-end was level 3-. The muscle strength of the right limbs was level 5. The muscle tone of the left upper limb was high. The muscle tone of the right limb was normal. The bilateral abdominal reflexes were normal. The left Babinski sign was positive. The left Hoffmann sign was positive. The examination of deep and shallow sensation in the body was normal. The right side did the finger-to-nose test and the heel-knee-shin test normally. The left side was unable to finish the digit opposition test, the rapid rotation test, the finger-to-nose test and the heel-knee-shin test. There were no signs of meningeal irritation.

Treatment:

After admission, Habiburrah received the relevant examinations. The patient received nerve regeneration treatment and stem cell activating treatment. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves, control blood pressure, activate the autologous stem cells and to nourish the neurons. This was combined with rehabilitation treatment.

Post treatment:

The muscle tone of the patient's left upper limb has been reduced to normal level, and the muscle strength has increased one level. The motor function is better than before. The range of motion of the left upper limb's near end has increased. He can raise the left arm to 150 degree from the bed surface. The left upper limb can raise and touch the forehead in a seated position. The left hand has grasp action, the hold power of the left hand is level 3. The left ring finger and little finger have small amplitude motion when the left hand has grasp action. The left thumb has adduction action. The movement of the left lower limb is better than before. The muscle strength of the left lower limb is better than before. His left foot can stretch backward or forward in a recumbent position. He can bend the knees and hips when he walks. The left foot can lift off the floor. He can stand with both tiptoes in an erect position. The patient's heart rate was slower than normal at admission. The lowest level was 49/min. After the treatment to increase the heart rate and protect cardiac function, the patient's heart rate is almost able to maintain between 58/min to 68/min.

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