Name
Capella University
PSYC FPX 3500
Prof. Name
December, 2024
Brain Injury Case Study
Case Study
Mr. Ahmed, a 65-year-old man, was presented to the emergency department after he had a fall at his home. His wife narrated that one day he started to slumber and he could not utter comprehensible words, his right arm and leg developed weakness. At the onset of the game, his consciousness level was decreased, and there was weakness on the right side of the face. The investigations showed that a CT scan of the head showed the ischemic stroke in the Middle Cerebral artery territory which in English means that the patient had an injury to the brain as a result of restricted blood flow. He was soon attended to to avoid more complications a sign of the seriousness of the hospital.
Signs and Symptoms of Stroke
The most common signs and symptoms of a stroke include:
- Weakness, numbness, or tingling in the face, arms, or legs – especially on one side of the body – that occurs suddenly.
- Confusion and or difficulty in speaking or comprehending spoken language.
- Abnormalities of vision in one or both eyes.
- Giddiness, Ataxia, or balance disorder.
- Headache of considerable intensity without a history.
These symptoms should be diagnosed early enough to reduce the effects of brain damage and enhance the result of the outcome.
FAST Acronym
The FAST acronym is a very basic yet potent tool that lets someone decide if it is a stroke and if yes, act immediately (Helboe et al., 2023). Prevention is important because if a person seeks treatment at an early stage the effects are minimized and the prognosis is so much better.
- F – Face: It is important to note that one of the clear symptoms of a stroke is a drooping or weak face, usually on the one side. To check for this, tell the person to smile. If the features on one side of the face look different or droop, it will be a sign of a stroke. This happens because the stroke causes physical damage to the region of the brain that controls the muscles of the face.
- A-Arms: Another one is that a person may have a feeling that one of his arms is becoming less sensitive, or even that he has lost the feeling in that arm. Refer the person to pull both arms up to their head. If one arm hangs low, or simply cannot be raised, then it can indicate a loss of muscle tone or control on that side, stroke being a case in point.
- S – Speech: A stroke is often experienced to affect speech; a person is unable to speak clearly or may stammer, mumble, or is completely unable to form words. Next, tell the person to say something like “The sky is blue”, and don’t say it for them. Impairment of either speaking or understanding speech is a very strong indicator of the presence of this condition.
- T – Time: The ‘T’ in FAST emphasizes the fact that time is of the essence. Any of these symptoms should be reported and Landing normally requires an emergency call to those in charge. The quicker the individual can gain medical help the lesser the impact on the brain and the greater the recovery rate. This is so because a lot of damage is done to the brain cells especially where they are denied oxygen.
Sources Supporting Diagnosis
CT and MRI Imaging
CT and MRI are the most commonly used diagnostic tools in stroke patients (Molteni et al., 2023). The first investigation of choice is a CT scan because of its fast execution time and accuracy in diagnosing hemorrhagic strokes, which are caused by bleeding in the brain. MRI gives clearer pictures and is useful in cases of ischemic strokes that result from a blood clot in one of the blood vessels supplying the brain. Such imaging tools also enable the definition of the specific area of a stroke, its dimensions, and the extent of its impact on treatment planning and the prognosis of patients’ recovery.
Blood Tests
Blood tests are obligatory for the evaluation of several values that could affect the stroke or mimic it. Coagulation or clotting time helps diagnose disorders like clotting or bleeding disorders. Serum glucose also gets measured as while low blood glucose levels present symptoms similar to stroke, high blood glucose levels are detrimental to stroke outcomes. Otherwise, further tests for cholesterol levels, infection, or organ function can be performed to try to establish the cause of the distress and direct the therapy accordingly.
Neurological Examination
Neurological examination is a clinical evaluation of a patient’s mental status, and sensory and motor systems to detect impairments due to a stroke (Sahuquillo & Dennis, 2019). These entail reflexes check, muscle power, coordination, vision, speech, or language commands, and language output. For instance, paralysis of an extremity or tremors, problems in speaking fluently, or being able to form proper sentences point towards the area of the brain that is damaged. This assessment gives initial leads as to the effects of the stroke in which to focus the early interventions based on the deficits incurred.
Electrocardiogram (ECG)
This test is a non-invasive one that reveals the electrical activity of the heart and can help in identifying the problems in the cardiovascular system that could have led to a stroke. Such diseases as atrial fibrillation affect clot formation and increase the risk of ischemic stroke (Longhitano et al., 2024). ECG identifies cardiac abnormalities that should be included in the treatment plan to manage stroke, including anticoagulant medication, cardiac procedures, etc.
That is why the combined use of these tools can lead to a correct diagnosis reveal the causes, and establish an individualized and efficient therapeutic plan.
Treatment Options
Immediate Treatment
For ischemic strokes, clot-dissolving medicine and especially tPA to be administered quickly, as it dissolves the clots that restrict blood flow to the brain. This treatment is most effective if it is carried out within 4.5 hours of complaint onset (Longley et al., 2021). The use of mechanical thrombectomy in patients with large clots may be done if endovascular procedures are required. This least invasive approach involves passing a catheter into the vessel and taking out the clot, which greatly enhances prognosis in selected cases.
Ongoing Management
Stroke requires long-term care both to cure the causes of the condition and to arrest the physical rebuild. Anticoagulants and antiplatelets are given to avoid the future formation of clots while the hypertensive drug is used to control high blood pressure which is an aspect of stroke (Shin et al., 2021). These treatments include physiotherapy for movement, occupational therapy for dailiness, and speech therapy for voice. Regular exercise, smoking cessation, weight loss, and improved diet, therefore, have special input in the prevention of the risk of a recurrent stroke.
Surgical Options
In extreme circumstances where swelling in the brain is dangerous decompressive surgery might be done to reduce ICP. Carotid endarterectomy is carried out for patients who have developed seizures or severe carotid stenosis wherein blockages in carotid arteries are severe enough to cause inadequate blood supply to the brain. These surgical interventions are very important to avoid a new stroke and to reduce the fatal outcomes of the complications.
PSYC FPX 3500 assessment 3 Conclusion
Stroke is a very dangerous disease and should be diagnosed and treated as soon as possible. This was perhaps the case of Ahmed, and such premature actions when some symptoms are noticed are being enhanced by tools such as the FAST acronym (Maresca et al., 2023). The main therapy includes thrombolytic therapy, which is followed by rehabilitation; however, it can lead to improved results. The current research findings suggest that community education and prevention approaches are critical in stopping or minimizing the incidence and effects of HI because of strokes.
PSYC FPX 3500 assessment 3 References
Helboe, K. S., Eddelien, H. S., & Kruuse, C. (2023). Visual symptoms in acute stroke – A systematic review of observational studies. Clinical Neurology and Neurosurgery, 229, 107749. https://doi.org/10.1016/j.clineuro.2023.107749
Longhitano, Y., Bottinelli, M., Pappalardo, F., Maj, G., Audo, A., Srejic, U., Rasulo, F. A., & Zanza, C. (2024). Electrocardiogram alterations in non-traumatic brain injury: a systematic review. Journal of Clinical Monitoring and Computing, 38(2), 407–414. https://doi.org/10.1007/s10877-023-01075-5
Longley, V., Hazelton, C., Heal, C., Pollock, A., Woodward-Nutt, K., Mitchell, C., Pobric, G., Vail, A., & Bowen, A. (2021). Non-pharmacological interventions for spatial neglect or inattention following stroke and other non-progressive brain injury. The Cochrane Database of Systematic Reviews, 7(7), CD003586. https://doi.org/10.1002/14651858.CD003586.pub4
Maresca, G., Lo Buono, V., Anselmo, A., Cardile, D., Formica, C., Latella, D., Quartarone, A., & Corallo, F. (2023). Traumatic brain injury and related antisocial behavioral outcomes: a systematic review. Medicine (Kaunas, Lithuania), 59(8), 1377. https://doi.org/10.3390/medicina59081377
Molteni, E., Canas, L. D. S., Briand, M. M., Estraneo, A., Font, C. C., Formisano, R., Fufaeva, E., Gosseries, O., Howarth, R. A., Lanteri, P., Licandro, G. I., Magee, W. L., Veeramuthu, V., Wilson, P., Yamaki, T., Slomine, B. S., & as the Special Interest Group on DoC of the International Brain Injury Association (IBIA-DoC SIG) (2023). Scoping review on the diagnosis, prognosis, and treatment of pediatric disorders of consciousness. Neurology, 101(6), e581–e593. https://doi.org/10.1212/WNL.0000000000207473
Panagiotou, K., Stefanou, G., Kourlaba, G., Athanasopoulos, D., Kassari, P., & Charmandari, E. (2024). The effect of time-restricted eating on cardiometabolic risk factors: A systematic review and meta-analysis. Nutrients, 16(21), 3700. https://doi.org/10.3390/nu16213700
Sahuquillo, J., & Dennis, J. A. (2019). Decompressive craniectomy for the treatment of high intracranial pressure in closed traumatic brain injury. The Cochrane Database of Systematic Reviews, 12(12), CD003983. https://doi.org/10.1002/14651858.CD003983.pub3
Shin, S. S., Hwang, M., Diaz-Arrastia, R., & Kilbaugh, T. J. (2021). Inhalational gases for neuroprotection in traumatic brain injury. Journal of Neurotrauma, 38(19), 2634–2651. https://doi.org/10.1089/neu.2021.0053