Vic is a karate instructor, approximately 40 years old. While sparring with one of his students, he found himself in a tight neck grasp. As he tried to free himself, he realized that his right arm and leg suddenly went limp and weak, and he was unable to speak.
After being rushed to the ER, Vic underwent a series of tests, including routine bloodwork, an electrocardiogram, a CAT scan, and an MRI. The CAT scan came back normal, but his bloodwork showed elevated cholesterol.
The MRI showed evidence of cerebral ischemia in the middle cerebral artery. There was no evidence of a cardiac embolism on a subsequent echocardiogram, although further testing showed a plaque in his carotid artery.
Once the doctors removed the plaque from his carotid, both his hemiplegia and his aphasia improved.
Vic was placed on a regimen of clopidogrel and Crestor and referred for speech therapy. He was also cautioned to avoid neck holds in the near future.
Questions
- What condition or conditions (there may be more than one possibility) are being described in this case? Does this involve brain damage, a specific disease or disorder, or some other condition that may be affecting the patient’s ability to move?
- What brain area or area(s) may be involved? Be specific, especially with regard to the hemisphere that would be most directly affected. How should they function normally? What could be causing this dysfunction?
- How would the treatments recommended affect the brain? How might those effects relate to the symptoms?
- How can you explain all of the symptoms exhibited by this case? Can you relate each symptom to a specific brain area or neurotransmitter?
- What other interventions may be possible, besides those noted here?
Remember to document your sources!
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