A 57 year old male presented to the Tulane Emergency department at 4:00 AM with the acute onset of right-sided facial drooping, speech slurring, and difficulty with lifting his right upper extremity.  Upon presentation, he is unable to communicate with medical staff, as he cannot get any words out; when asked about his birthday, he attempted to speak but was unable to produce any words, but he was able to write his birthdate down correctly when asked to do so. He was unable to lift his right arm, turn his head toward the right side, or He has a strong history of heart issues, dating back to his 40’s when he suffered from a myocardial infarction (heart attack) which required two stents placed in his left anterior descending (LAD) artery. He was prescribed Plavix (Clopidogrel) and aspirin 80 mg daily after his heart attack, and he was advised to stop smoking.  He had successfully stopped smoking for 2 months prior to restarting. He currently smokes 2 packs of Marlboro Menthol Light 100’s daily and lives on a steady diet of microwaveable Salisbury steaks and French fries.Given the acuity of his symptom presentation, neurological imaging via CT (computed tomography) and MRI (magnetic resonance imaging) was performed; imaging was revealing of a thrombus (clot) in the M1 segment of the middle cerebral artery, consistent with a stroke.Given the location of his stroke, would you expect him to have any sensory deficits?

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Asked Jul 10, 2019
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A 57 year old male presented to the Tulane Emergency department at 4:00 AM with the acute onset of right-sided facial drooping, speech slurring, and difficulty with lifting his right upper extremity.  Upon presentation, he is unable to communicate with medical staff, as he cannot get any words out; when asked about his birthday, he attempted to speak but was unable to produce any words, but he was able to write his birthdate down correctly when asked to do so. He was unable to lift his right arm, turn his head toward the right side, or

 

He has a strong history of heart issues, dating back to his 40’s when he suffered from a myocardial infarction (heart attack) which required two stents placed in his left anterior descending (LAD) artery. He was prescribed Plavix (Clopidogrel) and aspirin 80 mg daily after his heart attack, and he was advised to stop smoking.  He had successfully stopped smoking for 2 months prior to restarting. He currently smokes 2 packs of Marlboro Menthol Light 100’s daily and lives on a steady diet of microwaveable Salisbury steaks and French fries.

Given the acuity of his symptom presentation, neurological imaging via CT (computed tomography) and MRI (magnetic resonance imaging) was performed; imaging was revealing of a thrombus (clot) in the M1 segment of the middle cerebral artery, consistent with a stroke.

  • Given the location of his stroke, would you expect him to have any sensory deficits?
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Expert Answer

Step 1

Given, a 57-year-old male presented with acute onset of right-sided facial drooping, speech slurring, and difficulty with lifting his right upper extremity. He had suffered from myocardial infarction and placed with two stents in his left anterior descending artery. Further CT scan and MRI scan reveals the presence of a clot in the MI segment of the middle cerebral artery, consistent with a stroke.

Step 2

Arteries of the brain carry blood to supply oxygen and nutrients to the brain. There are different arteries travel to different regions of the brain as pipelines. The middle cerebral artery supplies blood to the temporal lobe, the parietal lobe, the internal capsule, the thalamus and a portion of the frontal lobe. The M1 segment of the middle cerebral artery is called a horizontal segment, which supplies blood to the basal ganglia. The basal ganglia are clusters of nerve cells responsible for controlling the involuntary movements.

Step 3

The blockage of blood flow in the arteries of the brain will result in a stroke. The middle cerebral artery stroke is caused by a blood clot that traveled from elsewhere in the body, typically from the heart or from the carotid artery, and lodged in the middle cerebral...

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