Hikmat El Halabi - Stroke sequela (Venezuela) Posted on July 3, 2014

Name: Hikmat El Halabi             
Sex: Male
Country: Venezuela
Age:61 years
Diagnoses: 1. Stroke sequela 2. Old myocardial infarction
Date:May 4, 2014
Days Admitted to Hospital: 18 days

Before treatment:
The patient received operation to remove aortic arch aneurysm 3 years ago. The patient suffered from acute subdural hematoma after the operation. Then the patient suffered from multiple cerebral infarction and right occipital lobe was more extensive and severe. He suffered from visual impairment and movement disorders of left limbs. The MRI examination of head showed he had stroke. The patient received medical treatment and had movement disorders of left limbs. He could walk with walking stick and left side presented with steppage gait. The patient had no genetic disease.

From the onset of disease, the patient had poor sleep quality and defecate 1-2 times each day.

Admission PE:
Bp: 124/71mmHg; Hr: 74/min, Br: 25/min. The temperature: 36.5 degrees. His nutrition was good. The respiratory sounds in both lungs were clear, with no dry or moist rales. The heart sound was low and blunt. The cardiac rhythm was regular, with no obvious murmur in the valves. The abdomen was enlarged and soft, it had tympanitic note when tapped. The liver and spleen were not palpable. There was mild edema in lower limbs. Both ankle joints had concavity edema.

Nervous System Examination:
Hikmat El Halabi was alert, the comprehension was okay. His computation ability was low. The examination of memory and orientation were normal. His left lower limb presented steppage gait.  With assistance of Tonfa sticks, he could walk. He spoke with plosion and the speech was unclear. He has strong muscles to close the eyes. He had blurred vision, only could identify outline of big objects. He has lost part of his color vision. Both pupils were equally round, the diameter was about 2.5mm. Both eyeballs were sensitive to light stimulus. Both eyeballs moved to the right side and was limited in movement. He has normal ability to blink. There was no nystagmus. The uvula and tongue were in the center. He had no swallowing difficulty and chew with strong muscle. The hearing ability was normal. The neck was soft. He has weak muscle to turn left side. The shrugging muscles of his left side was weak. The muscle strength of his left upper limb was at level 0. The muscle strength of left lower limb was at level 4. The muscle tone of his left upper limb was low. The deep sensation and shallow sensation of his left upper limb disappeared. The elaborate sensation of his left upper limb was low down. The shallow sensation of his left lower limb disappeared. The deep sensation and elaborate sensation of his left lower limb was low down. The tendon reflex of left upper limb was low down. Left side Rossilimo sign was positive. Left side Babinski sign was positive. His left side couldn’t cooperate with the coordinate movement examination. MRI of head: extensive right temporal lobe, occipital lobe softening lesion were seen.

Treatment:
Hikmat El Halabi received all the relevant examinations and he was diagnosed with stroke sequela. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and to nourish the neurons. He also received treatment to protect brain cells and to activate stem cells in vivo. This was combined with physical rehabilitation training.

Post treatment:
The fasting blood-glucose was normal after admission. The postprandial blood sugar for 2 hours after meal was 7.6-10.2mmol/L. The impaired glucose tolerance was considered. Doctor asked the patient to adjust the diet for the adjustment of the blood sugar. The patient suffered from acute gastroenteritis on the seventh day for the improper diet. He suffered acute angina. After symptomatic treatment, the acute gastroenteritis was cured. His vision has improved obviously, and his vision is clearer than before. He can identify time in clock face. The color perception ability has improved. The weakness of left limbs has disappeared, the muscle strength of left upper limb has reached level 2. The muscle strength of left lower limb is at level 4+. The muscle tone of left lower limb has increased. The patient can stand up from sitting position by himself. The walking gait is better than before.

(Download the Windows Media Player Firefox Plugin if you are using Firefox browser.
To know more,Please read Using the Windows Media Player plugin with Firefox.)

E-mail:

Date:2015-3-26

Greetings
Dr. Susan annexed the cardiac patient report hikmat the Halabi who received treatment with you in May last year, by brain injury CVD Hemorrhagic, currently the patient is conscious and alert, presents monoplegia in left upper limb after treatment in May the patient can make adducion shoulder and improves the visual field.