Help people!!!?

J.S. is a 72 year old woman with a long history of atherosclerosis. One afternoon, her grandson found her sitting in a chair staring blankly into space. She was tilting toward the right, drooling, and had been incontinent of urine. She was able to focus her eyes on him when he spoke to her, but she was unable to verbalize a response. She was transported to the local hospital and diagnosed with CVA

1. What questions could be asked of J.S.鈥檚 family to help determine the etiology of her stroke as thrombotic, embolic, or hemorrhagic (risk factors)?
2. Based on the scenario described, which brain hemisphere suffered the ischemic damage? What other manifestations of this stroke location would likely be apparent?
3. What therapies might be used to treat this CVA and/or prevent another stroke?
4. What information might be appropriate to give J.S.鈥檚 family about the expected recovery process after stroke?

Hi there

For question #1.
Ask if the patient has a history of intake of blood thinners- aspirin, warfarin, etc. these drugs can lead to a hemorrhagic cerebral bleeding. High blood pressure can also lead to hemorrhagic CVA. If a doctor can auscultate the neck, sometimes bruits can be appreciated on the affected carotid arteries. A duplex scan of the carotid arteries can determine or rule out if the stroke is thrombotic in nature. A history of a heart problem, especially left atrial or left ventricular clots can embolize to the brain. A 2d echocardiography can easily visualize these heart lesions.

for Question #2.
Its hard to tell which side is affected. a good neurologic physical examination may help. if she is coherent, she may be asked to stick out her tongue and we can find out to which side it is deviating. The muscle or difference in the muscle tone of both extremities can also point to the right or left involvement.

for question #3.
THe prevention of the next stroke is dependent on the factor which triggered it. These risk factors should be corrected, otherwise, another stroke is sure to happen.
Therapies are usually rehabilitative in nature. Of course, first thing to do is bring her to a neurologist, so that the underlying cause of the stroke can also be taken cared of.

For question #4.
A lot of factors can determine the prognosis or outcome of a stroke. It is best for the examining neurologist to give the more accurate details because its hard to tell from the data you posted here.