C.K is a 40-year-old male individual that experienced his first stroke one month ago. He was brought in with a speech impediment that developed when he got the stroke. The patient’s family quickly acted when he started experiencing a numb feeling in his right side with his arm contracting and bending at the elbow. C.K’s physician placed him on levofloxacin immediately after he arrived at the hospital. He did not have any allergies and was in good shape despite eating highly saturated fatty food. However, the patient exhibited signs of a stroke that resulted in difficulty communicating and articulating their thoughts. C.K’s family stated that he had not worked out since his early twenties and was constantly stressed working as a foreman for a local construction company. The patient exhibited stress because of these roles and was exposed to toxic fumes at work. He had worked in the industry for nineteen years and began this work as a painter while advancing his education in construction. As such, C.K was regularly exposed to paint fumes and worked in a strenuous environment. He came to the hospital for the first clinic accompanied by his wife and second-born child; his older son could not come because of a test at school. The patient has a wife (married for fifteen years) and two children.
Pathophysiology
A stroke is a rapid neurological upsurge due to impaired perfusion to the brain resulting from blood vessels. The most common prevalent form of stroke, Ischemic, accounts for 85% of stroke patient casualties (Grotta et al., 2021). It causes oxygen and blood deficiency supply to the brain. The other form, hemorrhagic stroke, results from leaky or bleeding blood vessels and is also referred to as intracerebral bleeding. Ischemic strokes lead to embolic and thrombotic issues in the brain. In the latter, atherosclerosis influences blood flow through the constriction of vessels. Plaque build-up ultimately forms clots and narrows the vascular chamber resulting in a thrombotic stroke (Hankey et al., 2019). An embolism results in reduced blood flow to the brain in the former. It leads to a reduction in the blood flow as the patient experiences extreme stress and necrosis. The plasma membrane gets disrupted as it progresses while organelles swell and cellular contents leak into extracellular pockets. The patient also experiences a neuronal function loss (Patnaik et al., 2019). Stroke pathology is also emphasized by issues such as energy failure, inflammation, excitotoxicity, acidosis, and oxidative stress.
Assessment
C.K showcased various communication problems when his family brought him to the hospital one month ago. He presented aphasia symptoms, exhibiting difficulty in understanding other people and speaking. C.K claimed that he noticed the issue when he was writing a response to an editor of one of his magazine subscriptions. In this instance, the patient could not read or write coherently and posited difficulty when communicating with his wife about his feelings. He also stated that he could not accurately understand her, signaling a problem with understanding language. C.K also illustrated frustration when communicating with others as they could not understand him clearly. After the initial examination, the patient’s physician discerned they had lost the ability to move their mouth, face, and throat muscles in the order required for speech. Therefore, the patient had developed apraxia of speech. While they demonstrated numbness in the right side, this feeling subsided within the first week and signaled the mild nature of C.K’s illness.
References
Grotta, J. C., Albers, G. W., Broderick, J. P., Kasner, S. E., Lo, E. H., Sacco, R. L., Wong, L. K., & Day, A. L. (2021). Stroke e-book pathophysiology, diagnosis, and management (7th ed.). Elsevier Health Sciences.
Hankey, G. J., Macleod, M., Gorelick, P. B., Chen, C., Caprio, F. Z., & Mattle, H. (2019). Warlow’s Stroke: Practical Management (4th ed.). John Wiley & Sons.
Patnaik, R., Tripathi, A. K., & Dwivedi, A. (2019). Advancement in the Pathophysiology of Cerebral Stroke. Springer.