ROLE OF AGNILEPA IN PAKSHAGHATA (ISCHEMIC STROKE): A CASE STUDY

2021 ◽  
Vol 12 (4) ◽  
pp. 4-8
Author(s):  
Padmavati Patil ◽  
Madhava Diggavi ◽  
Andanagouda S Patil
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Rapid Onset ◽  
Focal Neurological Deficit ◽  
Before And After ◽  
Acute Infarct ◽  
Maximum Improvement ◽  
Acute Condition ◽  
The Right ◽  
Developed Nations

Stroke is defined as the rapid onset of focal neurological deficit resulting from diseases of the cerebral vasculature and its contents. Stroke represents the third most common cause of death in the developed nations. The prevalence of stroke in India is approximately 200 per 100,000 persons and 9.94% of total deaths. The present article deals with a diagnosed case of ischemic stroke presenting with left sided hemiplegia Acute infarct in the right temporo-parieto-frontal lobe and right ganglio-capsular region with haemorrhagic transformation. The Ayurvedic diagnosis of vama Pakshaghata was made and managed with shamana aushadhi and agnilepa (bahirparimarjana chikitsa). Two assessments were made before and after treatment using the National Institute of Health Stroke Scale (NIH-SS) and CT scan. Maximum improvement was noticed in the symptoms of Stambha, Ruja, Supti, Shotha, Sparsha hani. Even there was also improvement in left upper and lower extremity functions. At the end of the treatment the patient could be able to walk without support. After treatment CT scan showed considerable recovery. Agnilepa plays a major role in the management of Margavaranajanya pakshaghata (acute ischemic stroke) if associated with saama condition, in acute condition. The drugs used for Agnilepa are having Katu Rasa Pradhana, ruksha, teekshna, lekhana guna, ushna veerya, katu vipaka and kaphavataghna, vedanasthapaka, Shothahara, Stambhahara, Suptihara and helpful in regaining of Sparshana. Agnilepa can be practiced as bahirparimarjana chikitsa in pakshaghata, as many Salvana upanaha are mentioned in the chikitsa.

AYURVEDIC MANAGEMENT OF PAKSHAGHATA (CEREBROVASCULAR ACCIDENT) A CASE STUDY

2021 ◽  
pp. 55-56
Author(s):  
Kavita B. Sutagatti ◽  
Pradeep L. Grampurohit ◽  
Vinayak B. Angadi ◽  
Ashwini Patil
Keyword(s):  
Causes Of Death ◽  
Hemorrhagic Stroke ◽  
Rapid Onset ◽  
Cerebral Vasculature ◽  
Midline Shift ◽  
Before And After ◽  
Maximum Improvement ◽  
Developed Nations ◽  
Acceptable Measure

Stroke represents the third most common cause of death in developed nations and is one of the leading causes of death and disability in India. Stroke is dened as the rapid onset of focal neurological decit resulting from cerebral vasculature and its contents. This disease has posed a great problem to the medical eld as far as its treatment is concerned. There is a wealth of information available on the cause, prevention, risk, and treatment of stroke. Even then much, less is known about the treatment of the stroke, there is no any satisfactory and widely acceptable measure for the stroke. The present article deals with the diagnosed case of hemorrhagic stroke presenting with right sided hemiplegia, Right basal ganglia bleed with epsilateral minimal midline shift. The Ayurvedic diagnosis of vama pakshaghata and managed with Virechana Karma (Detoxication therapy), Manjishtadi khseera basti (Administration of a medicated colloidal solution through rectum), Pratimarsha Nasya (Instillation of medicated oil through nasal route). Assessment was made before and after the treatment using National Institute of Health Score Scale (NIH-SS). Maximum improvement was noticed in the symptoms of aphasia and dysarthria. There was also improvement in the left upper and lower extremity functions. At the end of the treatment patient could walk without support. Panchakarma play a pivotal role in the management of stroke/ Pakshaghata. The recuperation was assuring and worth documenting.

scholarly journals The influence of nicergoline on cerebral, systemic and cardiac hemodynamics in patients who have had an ischemic stroke

2021 ◽  
pp. 17-26
Author(s):  
Viktor Kuznetsov
Keyword(s):  
Ischemic Stroke ◽  
Recovery Period ◽  
Peripheral Resistance ◽  
Cerebral Hemodynamics ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Cardiac Hemodynamics ◽  
Before And After ◽  
Blood Flow Velocities ◽  
The Right

The Aim of study was analysis of the effect of nicergoline on the cerebral, cardiac, systemic hemodynamics of patients after ischemic stroke, taking into account the hemispheric localization of the ischemic focus. Materials and methods. A comprehensive clinical and neurological examination was carried out in 38 elderly patients (mean age 64.3 ± 2.5 years) who had undergone atherothrombotic ischemic stroke in the carotid system (recovery period). There were 20 patients with left hemispheric stroke and 18 with right hemispheric stroke. All patients had arterial hypertension (AH). These were ACE inhibitors (enalapril 10-20 mg 1 tablet 2 times a day) and hydrochlorothiazide at a dose of 12.5 mg. Patients received nicergoline at a dose of 4 mg IV drip for 10 days. A comprehensive examination was carried out before and after treatment with nicergoline. The Results of the study allowed us to conclude that the course of nicergoline intake in patients after ischemic atherothrombotic stroke improves the subjective state and reduces the severity of neurological disorders, cerebral hemodynamics, increases linear systolic blood flow velocities (LBFVsys) and reduces peripheral resistance in individual extra- and intracranial vessels of the carotid and vertebro-basilar basins. In patients with right and left hemispheric localization of stroke under the influence of nicergoline, LBFVsys increases in the right and left ICA, PCA, and VA. In addition, LBFVsys increases in patients with right hemispheric stroke in the right MBA; in patients with left hemisphere - in two MBA and BA. In ischemic stroke patients, nicergoline affects systemic and cardiac hemodynamics: it reduces the systemic and cardiac hemodynamics, decreases the systemic vascular resistance and increases the ejection fraction, changes the structure of the relationship between systemic and cerebral hemodynamics, forming a positive relationship between blood pressure and hemodynamics in the vessels of the vertebro-basilar basin. Thus, the complex positive effect of nicergoline on various levels of cerebral, systemic and cardiac hemodynamics in ischemic stroke patients gives grounds to recommend the inclusion of this drug in the rehabilitation system of this category of patients.

scholarly journals Overview of The Head CT-Scan in Stroke Patients who was Treated at Muhammadiyah Hospital Palembang

2021 ◽  
Vol 2 (1) ◽  
pp. 24
Author(s):  
Pratrisna Yusastra ◽  
Indriyani Indriyani ◽  
Budi Utama
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Hemorrhagic Stroke ◽  
Right Hemisphere ◽  
Clinical Symptoms ◽  
Neurological Deficits ◽  
Thalamic Lesion ◽  
Stroke Patients ◽  
Head Ct ◽  
The Right

Background: Stroke is a collection of symptoms of neurological deficits due to sudden acute disturbance of brain function, both focal and global, caused by blockage or rupture of arteries and veins and proven by imaging and/or reflex pathology. Using CT-Scan, the description of acute phase stroke can be easier and can determine the appropriate treatment criteria for stroke. Purposes: To determine characteristic Head CT-Scan image of stroke patients hospitalized in Muhammadiyah Palembang Hospital. Methods: This study was conducted in a retrospective descriptive manner and obtained a sample of 41 stroke patients according to the inclusion and exclusion criteria using total sampling. Result: In this study, there were 28 patients (68.2%) with ischemic stroke and 13 patients (31.7%) with hemorrhagic stroke. Head CT-Scan image of ischemic stroke shows basal ganglia lesion (28.5%) and the right hemisphere lesions (57.1%) as the most predominant area. Head CT-Scan image of hemorrhagic stroke (58.3%) had intracerebral hemorrhage with the dominant thalamic lesion area (66.6%) and the right hemisphere (58.3%) had the most lesions with 8 patients (66, 6%) had a midline shift. Stroke patients were treated as experienced by the elderly (90.2%) and were dominated by the female sex (63.4%) and are dominated by clinical symptoms of hemiparesis (29.2%). Conclusion: Stroke patients at Muhammadiyah Palembang hospital dominated by ischemic stroke and on head CT Scan image predominantly shows lesions on the right cerebral hemisphere.

Cerebral contrast staining mimicking parenchymal haemorrhage in a stroke patient

2020 ◽  
Vol 13 (12) ◽  
pp. e236400
Author(s):  
Elvin Yuan Ting Lim ◽  
Saravana Kumar Swaminathan
Keyword(s):  
Ct Scan ◽  
Middle Cerebral Artery ◽  
Signs And Symptoms ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Iodinated Contrast ◽  
Acute Infarct ◽  
The Right ◽  
The Brain

A 75-year-old female patient presented with signs and symptoms of a right hemispheric syndrome. A CT scan of the brain with angiogram showed an acute infarct in the right middle cerebral artery (MCA) territory secondary to thromb-occlusion of the M1 segment of the right MCA. A follow-up CT scan 2 weeks later showed a large hyperdense region in the infarcted area. With the aid of a dual-energy CT scan, this was eventually shown to be due to contrast staining from an earlier administration of iodinated contrast on the same day, rather than frank haemorrhagic conversion of the recent right MCA infarct.

Abstract WMP16: Eloquence-Weighted Imaging Improves Clinical Outcomes Prediction in Endovascular Stroke Therapy

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Sunil A Sheth ◽  
David S Liebeskind ◽  
Conrad W Liang ◽  
Albert J Yoo ◽  
Reza Jahan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Acute Ischemic Stroke ◽  
Left Hemisphere ◽  
Right Hemisphere ◽  
Infarct Volume ◽  
Good Outcome ◽  
Relative Contribution ◽  
C Statistic ◽  
The Right

Background: Larger infarct size at presentation as determined by ASPECTS is associated with reduced likelihood of good outcome in acute ischemic stroke. However, infarct volume alone explains only a modest fraction (∼30%) of the variation in stroke outcome. Incorporating the relative eloquence of each ASPECTS region may improve the predictive power. Methods: In the combined database of the SWIFT and STAR trials, we identified patients treated with the Solitaire stent retriever. Using the 24hr CT scan, a multivariate linear regression was used to determine the relative contribution of each ASPECTS region, separately in each hemisphere, to freedom from disability (mRS 0-2) at 90 days. The coefficients from the regression were used to create an Eloquence-weighted ASPECTS score (EL-ASPECTS), which was compared against the original in predicting outcome based on the presentation CT scan. Results: Among 254 patients treated with ET, average age was 68, 64% were female, and NIHSS was mean 16 (SD +/- 5). Mean ASPECTS at presentation was 8.2 and 6.4 at 24 hrs. The most commonly involved ASPECTS regions were the lentiform nuclei (70%), insula (55%), and caudate (52%). In multivariate analysis, for the right hemisphere on 24hr CT, preservation of M1 (OR 1.6) and M4 (OR 1.2) regions were most strongly predictive of good outcome. For the left hemisphere on 24 hr CT, preservation of M3 (OR 2.6), and M5 (OR 2.5) and involvement of M2 (OR -1.9) were most predictive. Eloquence weights were assigned to all 20 R/L ASPECTS regions to create EL-ASPECTS. EL-ASPECTS, compared with original ASPECTS, demonstrated improved discrimination for independent functional outcome for right hemisphere (C-statistic 0.78 vs. 0.69), left hemisphere (0.78 vs. 0.72), and all stroke patients (0.76 vs. 0.70). On presentation CTs, multivariate analyses including age and presentation NIHSS demonstrated EL-ASPECTS but not original ASPECTS was predictive of good clinical outcome (OR 1.65, p<.01). Higher C-statistic values were seen with EL-ASPECTS in analysis of presentation CT scans. Conclusions: Incorporation of regional weighting into ASPECTS improves the ability to predict who will achieve independent functional outcomes with endovascular therapy in acute ischemic stroke.

scholarly journals Effects of rapid maxillary expansion on nasal cavity dimensions and airway resistance

2015 ◽  
Vol 2 ◽  
pp. 31-39
Author(s):  
Maria E. Tapia ◽  
Ursula Brethauer ◽  
Patricio Ulloa ◽  
Andrea Carcamo ◽  
Felipe Culaciati
Keyword(s):  
Ct Scan ◽  
Nasal Cavity ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Bite Block ◽  
Oral Breathing ◽  
Palatal Expansion ◽  
Before And After ◽  
The Right ◽  
Active Anterior Rhinomanometry

Background: Rapid maxillary expansion is a common treatment for posterior cross-bites that has also shown to improve nasal breathing.Methods: Thirteen oral breather patients with posterior cross-bite were studied. Treatment consisted in rapid maxillary expansion with a fully bonded appliance including a bite-block and a hyrax expansion screw. Before and after treatment, CT scans and active anterior rhinomanometry were performed to each patient. Data was analyzed with the non-parametric Wilcoxon statistical test and correlation between palatal expansion and increase of airflow in each patient was assessed.Results: The CT scan showed that transversal dimensions were significantly increased (P<0.001) in most areas after treatment, considering the right and left side separately. Rhinomanometry also showed statistical differences (P<0.001) in all parameters studied when compared before and after treatment. Positive correlation was observed between palatal expansion and increase of airflow.Conclusions: All patients improved oral breathing habit clinically and there is also statistical evidence that the nasal cavity increased its transversal dimensions, measured by CT scan and that patients increased their airflow through the nasal cavity, measured by rhinomanometry.

scholarly journals Segmental myoclonus and basilar artery giant aneurysm case report

1992 ◽  
Vol 50 (4) ◽  
pp. 528-530
Author(s):  
J. Pitágoras de Mattos ◽  
Ana L. Zuma de Rosso ◽  
Eduardo Zayen ◽  
Sérgio A. P. Novis
Keyword(s):  
Ischemic Stroke ◽  
Essential Hypertension ◽  
Case Report ◽  
Angina Pectoris ◽  
Ct Scan ◽  
Basilar Artery ◽  
Giant Aneurysm ◽  
Neurologic Examination ◽  
Babinski Sign ◽  
The Right

A 70 years-old man was admitted at our hospital because of unstable angina pectoris. He had essential hypertension and right hemiplegia from a ischemic stroke two years before admission. On neurologic examination, it was found mental disorientation, unstable emotionality, right spastic hemiparesis with right Babinski sign, and segmental myoclonus affecting the superior lip and the palate (palatal nystagmus) on the right side. On the CT scan, a giant aneurysm of the basilar artery was detected. We conclude that the segmental myoclonus could be explained by ischemic lesions in the Guillain - Mollaret triangle.

scholarly journals Heading Disorientation after Right Posteromedial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ritsuo Hashimoto ◽  
Noriyo Komori ◽  
Masako Abe
Keyword(s):  
Ischemic Stroke ◽  
Qualitative Analysis ◽  
Short Term ◽  
Significant Difference ◽  
Before And After ◽  
The Subject ◽  
The Right ◽  
Spatial Locations ◽  
Normal Controls ◽  
Error Types

We report the case of heading disorientation following ischemic stroke involving the right posteromedial areas. The patient was administered a new test named the Card Placing Test during which a subject was required to recreate an array of three cards, each of which was randomly placed on eight grids around the subject, before and after the subject’s rotation. Qualitative analysis of his performance after rotation revealed that over half of the errors comprised transposition and rotational offset. His score on the Card Placing Test was compared with those of normal controls(n=11). The results showed that his score on Card Placing Test after rotation was significantly lower than those of controls, whereas there was no significant difference between the case and controls in profile of error types. We infer that the heading disorientation observed in the present case was a result of a derangement of a short-term buffer that integrated information on spatial locations of objects with changes in body directions.

scholarly journals Acute prolonged motor aura resembling ischemic stroke after COVID − 19 vaccination (CoronaVac): the first case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wanakorn Rattanawong ◽  
Wasan Akaratanawat ◽  
Supatporn Tepmongkol ◽  
Aurauma Chutinet ◽  
Jarturon Tantivatana ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Right Hemisphere ◽  
Vital Signs ◽  
Imaging Study ◽  
Left Hemiparesis ◽  
Focal Neurological Deficit ◽  
Acute Infarction ◽  
First Case ◽  
Case Presentations ◽  
The Right

Abstract Background We report the first case of a patient who suffered transient focal neurological deficit mimicking stroke following CoronaVac vaccination. However, instead of an ischemic stroke, motor aura was suspected. Case presentations A 24 year-old Thai female presented with left hemiparesis fifteen minutes after receiving CoronaVac. She also had numbness of her left arm and legs, flashing lights, and headaches. On physical examination, her BMI was 32.8. Her vital signs were normal. She had moderate left hemiparesis (MRC grade III), numbness on her left face, arms, and legs. Her weakness continued for 5 days. A brain CT scan was done showing no evidence of acute infarction. Acute treatment with aspirin was given. MRI in conjunction with MRA was performed in which no restricted diffusion was seen. A SPECT was performed to evaluate the function of the brain showing significant hypoperfusion of the right hemisphere. The patient gradually improved and was discharged. Discussions In this study, we present the first case of stroke mimic after CoronaVac vaccination. After negative imaging studies had been performed repeatedly, we reach a conclusion that stroke is unlikely to be the cause. Presumably, this phenomenon could possibly have abnormal functional imaging study. Therefore, we believed that it might be due to cortical spreading depression, like migraine aura, which we had conducted a literature review.

Comparative Arterial Antithrombotic Activity of Clopidogrel and Acetyl Salicylic Acid in the Pig

1992 ◽  
Vol 68 (05) ◽  
pp. 500-505 ◽  
Author(s):  
Ch M Samama ◽  
Ph Bonnin ◽  
M Bonneau ◽  
G Pignaud ◽  
E Mazoyer ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Femoral Artery ◽  
Bleeding Time ◽  
Ex Vivo ◽  
Flow Reduction ◽  
Cyclic Flow ◽  
Left Femoral Artery ◽  
Before And After ◽  
The Right ◽  
Induced Aggregation

SummaryWe investigated the comparative antithrombotic properties of clopidogrel, an analogue of ticlopidine, and aspirin, using the Folts' model on femoral arteries in 22 pigs. On each animal, clopidogrel or aspirin were used to treat the thrombotic process on the left femoral artery and to prevent this process on the right femoral artery. Sequentially: an injury and stenosis were carried out on the left femoral artery; the thrombotic process was monitored with a Doppler during a 30-min observation period for cyclic flow reductions or permanent cessation of flow; after the first cyclic flow reduction occurred, clopidogrel (5 mg kg-1) or aspirin (2.5, 5, 100 mg kg-1) were injected intravenously; if cyclic flow reductions were abolished, epinephrine (0.4 µg kg-1 min-1) was injected to try to restore cyclic flow reductions and/or permanent cessation of flow; then injury and stenosis were applied on the right femoral artery. Before and after injection of clopidogrel or aspirin, ear immersion bleeding times and ex-vivo platelet aggregation were performed. Clopidogrel (n = 7) abolished cyclic flow reductions in all animals and epinephrine did not restore any cyclic flow reduction. On the right femoral artery, cyclic flow reductions were efficiently prevented, even for two injuries. Basal bleeding time (5 min 28) was lengthened (>15 min, 30 min after clopidogrel and remained prolonged even after 24 h). ADP-induced platelet aggregation was inhibited (more than 78%). Comparatively, aspirin had a moderate and no dose-dependent effect. Aspirin 2.5 mg kg-1 (n = 6) abolished cyclic flow reductions in 2 animals, CFR reoccurred spontaneously in one animal and epinephrine restored it in a second animal. Aspirin 5 mg kg-1 (n = 6) abolished cyclic flow reductions in only 3 animals and epinephrine always restored it. Aspirin 100 mg kg-1 (n = 3) was unable to abolish cyclic flow reductions. On the right femoral artery, aspirin did not significantly prevent cyclic flow reductions which occurred in all animals after one (n = 14) or two injuries (n = 1), except for one animal. Basal bleeding time was lengthened but it shortened rapidly, reaching its basal value after 24 h. ADP-induced aggregation was not significantly inhibited, whereas arachidonic acid induced aggregation was always inhibited. Clopidogrel appears as a more potent antithrombotic drug than aspirin in this model, in treating and preventing spontaneous or epinephrine-induced cyclic flow reductions and lengthening bleeding time.

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