HEMIPLEGIA - Clinical case presentation

[@drasifpatel1716]

Easy way to remember: Life of PAI(plasminogen Activator Inhibitor) begins in the morning! Cause of increased thrombotic strokes/MI in the early morning hours

[@asamvav]

I liked Dr. Baloor's way of questioning and calmness in explaining. Very good for an examinee. Good presentation from the student's end.

[@sakshikumari7349]

What is the dofference in progression of hemorrhagic and thrombotic stroke?

[@Little-v2x]

​@@sakshikumari7349The difference is time of occurance..progession almost looks similar.. Also can be differentiated on symptoms headache, vomiting in hemorrhagic stroke is classical

[@tawfiqahmad8082]

Before watching the video completely, i want to take a minute to appreciate Ms. Rekha. You are you going to be a great doctor. You almost answered every question. I am soo happy for you.

[@parthkulkarni8309]

Mam almost answered all questions…. 😱😱😱

[@krisshhnaa5074]

😱😱😱

[@dryash866]

That's bcoz she already heard sir's class

[@tejasolanki5999]

@@dryash866 which class??

[@medinindia885]

Namaste sadguru 😁

[@natarajumididoddi5985]

It is a very good clinical case presentation and discussion. I am a family practitioner, (practising)76y.I appreciate the student' presentation .I learnt a lot about hemiplegia, how to diagnose ischemic haemorrhagic and embolic strokes. I wish I were your student. Thanks

[@moinalijanvekar9391]

Salute to the girl she is very knowledgeable

[@___s___8071]

1:07:43 CADASIL is Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

[@manojk6531]

Early morning presentation of thrombotic stroke is due to Cortisol rise in body which cause vasoconstriction leading to Stroke is what a professor in my college had said

[@drsiddharthsoniphysician]

Mesmerising presentation and very insightful and indepth discussion by Bolloor sir who is a gifted teacher. Voice of presenter is very clear and soothing type. @

[@dr.hitendrakumar9338]

Yes boss 👌

[@tarunjha3257]

Hands down the best case presentation i watched ever in my life

[@ijaziqbal1539]

great teacher ..... teaching from heart....... best source for clinical exam prepration ....... true name of teacher

[@___s___8071]

1:12:11 stroke mimics SOL Migraine Meningitis Hypo/Hyperglycemia Todd's paralysis

[@anasahmad6749]

24-7 hr in Todd's

[@meenakshi6344]

Very useful. Plus Ms Rekha did brilliantly.

[@anandtiwari52]

Admin, succeeded in maintaining the communication.......good quality audio and video this time, weldone Sir.

[@nsas955]

Really an amazing and fruitful presentation . I admire the way of presenting the case as well as the questions and discussions. God bless you both.

[@kapilchandrothiya3316]

Wow What a Case Presentation 🎉Dr Boolor Sir is Amazing🤩 Must watch !!

[@satyamp6202]

Thank you so much entire team, great efforts 🙏🙏🙏🙏, thank you so much sir for your valuable time....

[@anirbanpaulrollno6067]

Thanks sir for explaining the concept in a very nice way ❤

[@breezeofease6373]

sir pls bring the case presentation over parkinsonism with archit baloor sir ... the way he explain helped me a lot while my case presentation 💓💓💓

[@anasahmad6749]

1:02:08 htn Ischemic > hemorrhagic but both possible Lacunar infarcts very small vessels .3-1.5 cm size

[@anasahmad6749]

Pure motor Or pure sensory Or hemiballismus Lacunar infarcts Post limb of IC >> genu, thalamus

[@narasimha7870]

Why UMN lesions have distal muscle weakness first any logic? Because if UMN supplying proximal muscle involved ,then patient will have only proximal muscle weakness…..

[@nadeem3rashid]

Wow ! Very Well presneted for a UG 👌🏼

[@itsgabriel2691]

Doing a great job sir 🙏🙏🙏 keep posting S Help a lot of solving doubts Nice discussion sir ma'am give aprrox all the answer

[@anasahmad6749]

1:26:47 ischemic stroke don't reduce bp achanak se as penumbra ko bachata hai Redce slowly While hemorrhagic stroke eg if bleed..reduce

[@tube442]

She doesn't look like undergraduate

[@gajananrepal3847]

Thank you so much Archit sir .....very comprehensive

[@pramodgowdar9760]

Ms Rekha answered everything but lill anatomical basics and surface anatomy she needs to know ... Thats it

[@anandtiwari52]

Discussion has been thorough and so very valuable.

[@BharathKumar-we3ng]

Omg is it undergraduate student who presented

[@rizvyrahman3837]

Thanks❤... Archit sir is as always great

[@arpanuppal0007]

Such an amazing discussion ❤️

[@anasahmad6749]

1:28:40 increased ict pe decreased RR + Certain soecific patterns eg cheyne stomes etc

[@pranavlokeshgp83]

Really good! Gonna prepare for my case based on this 👍🏽

[@sayanthvishnusubramanian8893]

😅

[@natarajumididoddi5985]

Sir in my experience I witnessed in icu (I work as a duty doctor now as well) a few traumatic SAH.

[@anasahmad6749]

LOC hemorrhagic or large infarct Cortex and RAS (brainstem ) involved in alertness consciousness

[@anasahmad6749]

Doubt..Deviated face towards ? 27:50 Umn cl Lmn il Brainstem lmn opposite side of stroke Above cortical on side of stroke

[@SB-uc8ph]

Beautiful🎉❤

[@mdmillatreza9501]

Amazing discussion

[@akv41av]

Nice presentation n discussion 👍

[@AshokKumar-bm4bp]

Thank you very much archit sir 🙏

[@anasahmad6749]

1:15:08 do not forget autonomic fn...asked for lateral medullary synd

[@anasahmad6749]

Horners mainly

[@anasahmad6749]

Cervical cord inv(rarely)

[@anasahmad6749]

Timing Deficit at onset Progression For type of stroke based on history

[@anasahmad6749]

1:18:20 relevance of pulse in stroke...irregularly regular pulse in a fib Raised ict decrease?? in pulse Bradycardia cushings reflex Arterial wall palpable and thickened in severe atherosclerosis Peripheral pulses absent feeble in vascular diseases and variuous cardiac diseases... valvular ds AR - WATERHAMMER AS - ANACROTIC pulsus parvus et tardus Pulse mein rhythm volume character and arterial wall ke ilaawa also auscutate CAROTID bruit

[@anasahmad6749]

Also for posterior circulation ... vertebral artery(from subclavian 1st part) mei check bruit...straight line from medial end of clavicle and mastoid... surface anat. Of vertebral artery and arising from there it goes up thru transverse foramen of vertebra

[@anasahmad6749]

No bruit only rules out ...possible ke complete occlusion ho jayega

[@anasahmad6749]

No bruit in complete occlusion....bruit in 30-70 percent occlusion 1:25:23

[@anasahmad6749]

1:28:04 watershed infarct- in multiple areas

[@sakshikishen3750]

Great discussion!

[@anasahmad6749]

1:35:57 Spasticity not rigidity bcz only antigravity muscles i.e flexors in upper limb and extensors in lower limb affected

[@anasahmad6749]

Rigidity all muscles affected

[@anasahmad6749]

Spasticity has clonus+ babinsky sign Spasticity is velocity dependent ...vel increase krne pr spasticity also increases whereasd rigidity increases Spasticity is Clasp knife spasticity pattern while rigidity is lead pipe pattern

[@tarunjha3257]

Kuddos to the presenter calm cool and super intelligent

[@anasahmad6749]

1:32:23 in fundoscopy subhyaloid space- boat shaped...dursen's syndrome

[@narasimha7870]

Mechanism of fever in venous strokes and why fever doesn’t happen in arterial stroke??

[@GauravPawar-vl7jb]

No deliveryof inflammatory mediators in case of arterial stroke

[@rahullinton]

So much helpful sir❤❤❤❤

[@asfiyafakiha]

Thankyou sir. 😊

[@anasahmad6749]

1:16:47 xanthomas etc for metabolic synd,

[@anasahmad6749]

Temp high bad prognosis Hyper pyrexia in endocarditis , pontine lesions,meningitis, venous strokes eg due to DVT

[@nishithmohapatra7206]

Why posterior limb of internal capsule stroke localization

[@anasahmad6749]

Aphasia localises to cortex dosorder of language Dysarthria articulation affected brainstem or any cranial nerve eg 7, 9 , 10 , 12

[@anasahmad6749]

1:09:56 young female ho toask menstrual history Ocp Apla syndrome history etc

[@anasahmad6749]

1:41:49 3 and below power u can't do cerebellar

[@anasahmad6749]

Facial nerve(since face dev) involved therefore PPPPP wali sound lips inv.. in sounds mei dysarthria

[@anasahmad6749]

Iç lesion not produces aphasia ...therefore 2 lesions

[@anasahmad6749]

Word out put females more

[@anasahmad6749]

Edh or sdh hematoma may lead to hemiplegia kind of symptoms

[@Dr.GAURAV45]

Internal capsule involved, so why hemiparesis and not hemiplegia?

[@GauravPawar-vl7jb]

Don't say hemiplegia until zero power

[@mahimabhojwani2908]

Is it left side or right side umnl at 1:35:05

[@GauravPawar-vl7jb]

In umn distal weakness start first eg in fingers

[@sachinkambar.9816]

How sensory components intact if internal capsule involved

[@romanchitupadhyaya3738]

Can we have a case presentation like this on paraplegia also sir regarding the approach and all 🙏

[@THEWHITEARMY]

we already have many a discussion videos on paraplegia..kindly check

[@anasahmad6749]

Raised ict in hemorrhagic, or large thrombotic

[@ruhinaresh7410]

Very useful 👍

[@anasahmad6749]

Umn lesion first has distal motor weakness

[@anasahmad6749]

Only lower part of face affected therefore UMN type

[@lavanyakumhar8021]

How is this hemiplegia but not hemiparesis

[@sakshikumari7349]

What is the difference in progression of thrombotic & hemorhagic stroke? Can it be differentiated clinically?

[@Little-v2x]

Both have almost same progression.. But vary in time of occurance.. Symptom wise hemorrhagic will be have raised ict with Heachache, vomiting

[@mr.x1363]

V nice 👍

[@Drstrange12233]

Sir provisional diagnosis i think it is left sided umn facial palsy as on examination we have loss of nasolabial folds on right side so contralateral will be left facial palsy

[@AravindRavi]

i also made the same confusion during my models. if the patient has loss of nasolabial fold on the right side and deviation of angle of mouth to the left. then we call it right sided facial palsy only but the lesion is on the left side (if its an UMN) . its quite tricky but we have to be careful while answering

[@anasahmad6749]

1:44:44 treatment

[@mohitzambare]

Can someone explain the planter response why is it like that?

[@sanjujohn6383]

Very good

[@ayushmanmukherjee9297]

Here, the history of deviation of angle of mouth as taken, will be right sided and not left sided.... M i right?

[@medicalknowledge7950]

Sir,can u make subtitles available for this vedio ? I have some hearing problem

[@DrChainSingh]

Thank you sir

[@wmaperera]

Well done sir...thanks u..

[@ravibhoria5563]

Who's the girl presenting the case??

[@anasahmad6749]

Dense hemiplegia localises to IC

[@adarshpal4907]

Kadak,🤗🤗

[@krisshhnaa5074]

Don’t be like layman man…

[@shashankgowda2208]

Using India language in no way makes u layman .. knowledge is imp

[@shashwatchaurasia9030]

Hello medicos, Does anyone have notes regarding this video discussion?

[@nekoprogressive1504]

b$d₹ khud toh kuch mehnat karle sub dusro se hi bheek manenga kya,itna accha padhaya hai sir ne,kuch kadar kar M©️

[@dancewithamaskmask7230]

Did you get notes . I also would like to get them

[@jeetdattani5535]

@@dancewithamaskmask7230 ? Did you got notes?

[@anasahmad6749]

1:08:54 pure veg b12 def homocysteiimia

[@anasahmad6749]

Hyper homocysteine

[@anasahmad6749]

Alcohol cocaine smoking Std like hiv may have

[@GauravPawar-vl7jb]

Umn type of facial nerve palsy

[@imperialalike1536]

Mangalore 🔥

[@ahmadgumman3390]

LMN FACIAL PALSY WILL GIVE YOU IPSILATERAL PALSY??

[@kishanvishwamitra7727]

Chassignac tubercle

[@drvijayfromkem6934]

Thank you to all

[@ViratKohli-yi1xr]

Do we have to know everything like here ?

[@anasahmad6749]

Rf here Post menopausal Female Old Htn

[@prantikdas9974]

Woww 🔥

[@k.charitachowdary1130]

1:26 speech

[@kalyanirathod8683]

👏👏

[@dr.vigneshwar5747]

👌

[@docchethanr]

1:07:38

[@kirankumarch9954]

I want pdf of this video

[@anasahmad6749]

1:34:54 ??

[@anasahmad6749]

Tia r/o ke liye transient loss of vison(pertaining to anterior circulation carotid srtery-amaurosis fugax,..opthalmoc art inv.>>> monoparesis, sensory loss aphasia Or posterior circulation vertebrobasal...weakness in iol(cranial nerves) , vertigo (ataxia) hiccoughs If More than 2 tia ..rx. put on anti platelets Tia indicstes ischemic stroke....can be thrombotic or embolic stroke Tia rules out hemorrhagic stroke Now embolic recurrent short lasting deficit different features each time Thrombotic stroke longer duration in bw...vessel is narrowed ..same vessel damaged..same features each time Tia - 7 times increased risk of getting stroke 60-70% will get a stroke Majority will get. A stroke in first week...rest in first 3 months Abcd2 score

[@anasahmad6749]

No history of seizures r/o cortical inv

[@anasahmad6749]

Meningitis fever vascular inflammation...eg tb (chronic).. may cause stroke??????

[@anasahmad6749]

Involuntary inv basal ganglia No urinary and fecal incontinence...seizures...as present in post ictal

[@anasahmad6749]

LOS IC c/l Lateral medullary synd Thalamic - burning pain

[@anasahmad6749]

LOB -Cerebellar stroke Also commentrd if power normal otherwise power ki wjh se bhi

[@bhuwansubedi4556]

Menstrual history missing

[@GauravPawar-vl7jb]

Kya karna hai vo leke