A.

MANAGEMENT

1. DIAGNOSTIC TESTS, TREATMENTS, PROCEDURE and SURGERY A. Diagnostic Tests Diagnostic tests and procedures are vital tools that help physicians confirm or rule out the presence of a neurological disorder or other medical condition. A century ago, the only

way to make a positive diagnosis for many neurological disorders was by performing an autopsy after a patient had died. But

decades of basic research into the characteristics of disease, and the development of techniques that allow scientists to see inside the living brain and monitor nervous system activity as it occurs, have given doctors powerful and accurate tools to diagnose disease and to test how well a particular therapy may be working. Stroke neurological is diagnosed through blood several tests, CT techniques: scans, MRI a short scans,

examination,

Doppler ultrasound, and arteriography.

The initial diagnostic

test for a stroke is a noncontrast computed tomography (CT) scan performed emergently to determine if the event is ischemic or hemorrhagic. Further diagnostic workup for ischemic stroke

involves attempting to identify the source of the thrombi or emboli. A 12-lead electrocardiogram (ECG) and a carotid

ultrasound are standard test. Other studies may include cerebral angiography; trans-cranial Doppler flow studies; trans-thoracic

or trans-esophageal echocardiography; magnetic resonance imaging (MRI) of the brain, neck, or both; xenon-enhanced CT scan; and single photon emission CT (SPECT) scan. However, we will focus our discussion on CT scan and other clinical chemical test only because my patient was not able to afford other test like MRI and so CT scan was the only diagnostic test done to him.

1. Computed Tomography Scan (CT Scan) A CT (computerised tomography) scanner is a special kind of X-ray machine. Instead of sending out a single X-ray through your body as with ordinary X-rays, several beams are sent

simultaneously from different angles. The purposes of CT scan are: a. b. c. d. e. to diagnose intracranial lesions and abnormalities, to monitor the effects treatment of intracranial tumors, to guide cranial surgery, to assess focal neurologic abnormalities, to evaluate suspected head injury, such as subdural

hematoma. The most common complication of CT scan is adverse reaction to iodinated contrast medium. The result of CT scan will be determined normal if brain matter appears in shades of gray and ventricular and subarachnoid cerebrospinal fluid appears black. Areas of altered density or displaced vasculature or other

structures is considered as abnormal findings and may indicate intracranial tumors, intracranial hematomas, cerebral atrophy, infarction, hydrocephalus. edema, and congenital anomalies such as

My client had undergone CT scan on November 27, 2010 and the impressions were: * Recent infarctsleft mid-cerebral artery, thalamus,

temporal and frontal lobes.

2.

COMPLETE BLOOD COUNT

General survey of bone marrow functions and evaluates all three cell lines (WBC, RBC and platelets). Important to note changes over time; many hematologic conditions show changes in CBC long before the patient becomes symptomatic.

Result of my patient CBC (November 27, 2010) Test WBC Count RBC Count Hemoglobin Hematocrit Platelet count: Result 7.6 4.17 132 0.39 316 Normal Value 5.0-10 x109/L 4.5-6.5 x 1012/L M: 140-170 g/L M: 0.40-0.50 g/L 150-400 x 109/L

Indications: the result shows the decrease level of hemoglobin and hematocrit