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Michael is a 61 year old Senior Partner in a Law Firm. While eating breakfast Michael experienced sudden
onset slurring of speech, had facial droop on his left hand side with weakness in left side upper and lower
limbs. Michael's wife Mary spotted these sudden onset of symptoms and immediately called for an
ambulance, which arrived within 15 mins.
Asthma - Dx Aged 8
Medication History
Seretide Accuhaler
Thiazide
Social History
61 Year Old Senior Partner at a Law Firm, recently reduced working hours 20 - 30 hours per week,
previously worked 50 - 60 Hours
Planning on retirement in 1 - 2 years
Lives in a Bungalow with his wife Mary, who is a recently Retired Teacher.
2 Adult Children, both married with their own children - 1 lives close by, the other lives overseas.
Outside work he enjoys golf, usually playing at least 2-3 per week. Also enjoys playing Bridge with Friends.
Took up walking 3 Years ago following Dx Prediabetes. Walks 5 - 6 days per week for between 30 - 45 mins
Social Beer Drinker 10 - 15 Standard Drinks per week with 3 - 4 per session, although sometimes after Golf
may be more.
Pre-Hospital Assessment
Vitals:
BP 140/90 mmHg
Pulse 75
Physical Exam:
BP 145/90 mmHg
Pulse 82
Physical Exam:
Confusion
Left Facial Droop
Slurred Speech
Left Motor Weakness Upper Limb 0/5, Lower Limb 2/5
Decreased Tone
Altered Sensation
Mild Left Sided Neglect
Labs:
CT:
Hyperdensity in the M1 Segment of the Right Middle Cerebral Artery, with no other signs suggestive of
an Ischemic Stroke noted.
Provisional diagnosis of Acute Ischemic Stroke secondary to occlusion of the M1 was made
Patient was treated with intravenous Tissue Plasminogen Activator (tPA) at 1 h 54 min after symptom
onset
MRI:
Multimodal MRI Scan completed at 3 h 09 min after symptom onset demonstrated Ischemic Changes
confined predominantly to the Right Middle Cerebral Artery
Perfusion-weighted MRI showed larger perfusion abnormality, indicating presence of a substantial
volume of potentially salvageable penumbral tissue.
Time-of-flight magnetic resonance angiography showed a loss of signal in the Right Internal Carotid
Artery and Middle Cerebral Artery.
Cerebral Angiography
Cerebral angiogram performed post MRI demonstrated Occlusive Thrombus extending from the Right
Internal Carotid Artery Origin through the Right Middle Cerebral Artery Trunk.
Recanalization was attempted by Endovascular Thrombectomy performed 4 h 19 min after symptom
onset
Medical Management
Stroke Unit:
Paciente masculino de 68 de edad con Dx médico de Parálisis de bell, al realizar la valoración presenta dificultad para hablar, lado izquierdo de su
rostro se nota caída al igual que su extremidad superior e inferior izquierda presenta debilidad. Presenta limitación para retomar sus labores
como bufete de abogados y realizar actividades como jugar Golf. Esto está asociado con el patrón D en el sistema osteomuscular que trata sobre
deficiencia con movilidad articular, función motora, desempeño muscular y rango de movimiento asociado con difusión de tejido conectivo
Estado E MB B R M 1 2 3 4 5 o Ocupación:
general de Socio senior en bufete de abogados
salud:
LIMIT
ACION
RESTRICCIONES
DEFICIENCIAS Código DEFICIENCIAS Código ES EN
Calificador Calificador Código CIF Calificador EN LA
FUNCIONALES CIF ESTRUCTURALES CIF LAS
PARTICIPACIÓN
ACTIVI
DADES
Sensación asociada con los B220 Musculatura de S7104. Mante D 415 B 7350
ojos y estatura adyacentes cabeza y cuello 2 ner Tono muscular
postur ailado y grupos de
a del músculos
cuerpo
Función con el tono B735 Estatura de S1106. Hablar D330.2 D 920 trabajo
muscular nervios 2
Llevar a cabo rutinas d230 Estructura de la S750 Comer D 859
diarias extremidad y D550.2/ d560 Tiempo libre
inferior beber
Trabajo remunerado Estructuras s798 Cambi d429 b2801
d850 relacionadas con ar y Dolor en una
el movimiento, mante parte del cuerpo
otras ner la
especificadas posició
n del
cuerpo
, otra
especi
ficada
y no
especi
ficada
Función vestibular b2352 Estatura de la S730 posar d 4305 d450 Andar
relacionada con el extremidad objeto
movimiento superior s
AS RELEVANTES, DESDE LA PERSPECTIVA DEL FISIOTERAPEUTA
PRONOSTICO
INTERVENCION
META LOGRO METODO DE INTERVENCION PRESCRIPCIÓN