55 yr old male with cerebrovascular accident

55 year old male with Cerebrovascular accident 

December 26, 2022
 55 year old male a goat Heder from Gouraram came to the department on 23/ 12 / 2022 with chief complaints of weakness in left upper arm associated with sudden involuntary moments. 

HOPI- Patient was asymptomatic 10 days back. On 17/ 12/ 22 he developed sudden involuntary moments on the left upper limb associated with weakness and loss of speech. The patient was taken to a hospital in nalgonda where he was admitted and the following tests were done- 
-MRI brain
-CBP
-Echocardiogram 
- Lipid profile 
- CT cerebral angiogram 
- ECG
-LFT
- CT neck angiogram 
-Renal function test 
The following medication was prescribed- 
- Metformin hydrochloride sustained release tablets ip - 500mg
- Atorvastatin tablets ip- 40mg
- pantopazole gastroresistant - 40mg and domperidone prolonged release 30mg gelatin capsule.
- clopidogrel - 75mg and aspirin - 150mg capsules 
- Cefixime and Lactic acid bascillus dispersable tablets 
- Telmisartan tablets - 40mg 
- soluble insulin injection 40 IU/ ml 
- cerebroprotein hydrolase injection 
- lignocain hydrochloride gel. 
The patient was discharged from the hospital on Thursday morning( he had gained his speech by then but had a slurred speech) after which he had administered these medications once which was followed by an episode of vomiting the next day.The patient could walk only with a support.  On Friday night ( 23/ 12/ 2022) the patient developed sudden involuntary moments in his left upper arm for 2 min after which he was brought to the casuality that night and was admitted. On Sunday night he had an episode of vomiting after eating dosa for dinner. Today ( 26/12/ 2022) he complained of burning micturition and slight blood in urine. 

Past history -  He was diagnosed with diabetes 5 years back and stopped having medications 1 year back . One month ago he had a head injury with a transformer and followed by stampede by his goats while he was trying to protect them. After this he has developed a severe contimuous headache on his left temporal region.He was diagnosed with Hypertension last week when he was admitted in nalgonda.

Personal history-
 -Adequate sleep 
- Increased appetite after stoppage of medicines but his appetite decreased since 1 week 
- Mixed diet 
- bladder and Bowel moments normal 
- no addictions 
Family history - none 
Drug history - none 

Investigations - 
- done in hospital in nalgonda 

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