HEMIPLEGIA - Clinical case presentation

[@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.

[@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

[@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

[@parthkulkarni8309]

Mam almost answered all questions…. 😱😱😱

[@krisshhnaa5074]

😱😱😱

[@dryash866]

That's bcoz she already heard sir's class

[@tejasolanki5999]

@@dryash866 which class??

[@medinindia885]

Namaste sadguru 😁

[@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

[@tarunjha3257]

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

[@___s___8071]

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

[@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 👌

[@ijaziqbal1539]

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

[@meenakshi6344]

Very useful. Plus Ms Rekha did brilliantly.

[@___s___8071]

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

[@anasahmad6749]

24-7 hr in Todd's

[@anirbanpaulrollno6067]

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

[@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

[@satyamp6202]

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

[@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 💓💓💓

[@kapilchandrothiya3316]

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

[@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…..

[@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.

[@tube442]

She doesn't look like undergraduate

[@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

[@anandtiwari52]

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

[@BharathKumar-we3ng]

Omg is it undergraduate student who presented

[@nadeem3rashid]

Wow ! Very Well presneted for a UG 👌🏼

[@gajananrepal3847]

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

[@anasahmad6749]

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

[@anasahmad6749]

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

[@natarajumididoddi5985]

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

[@pawanpawar1303]

Greatest case and discussion❤nice explanation sir…the only hmm I like after Shreya Ghoshal 😅

[@akv41av]

Nice presentation n discussion 👍

[@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🎉❤

[@arpanuppal0007]

Such an amazing discussion ❤️

[@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

[@mdmillatreza9501]

Amazing discussion

[@anandtiwari52]

Discussion has been thorough and so very valuable.

[@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]

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

[@anasahmad6749]

Horners mainly

[@anasahmad6749]

Cervical cord inv(rarely)

[@rizvyrahman3837]

Thanks❤... Archit sir is as always great

[@pranavlokeshgp83]

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

[@sayanthvishnusubramanian8893]

😅

[@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

[@sakshikishen3750]

Great discussion!

[@AshokKumar-bm4bp]

Thank you very much archit sir 🙏

[@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]

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]

Edh or sdh hematoma may lead to hemiplegia kind of symptoms

[@nishithmohapatra7206]

Why posterior limb of internal capsule stroke localization

[@anasahmad6749]

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

[@pramodgowdar9760]

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

[@sachinkambar.9816]

How sensory components intact if internal capsule involved

[@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

[@anasahmad6749]

1:28:04 watershed infarct- in multiple areas

[@mahimabhojwani2908]

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

[@Dr.GAURAV45]

Internal capsule involved, so why hemiparesis and not hemiplegia?

[@GauravPawar-vl7jb]

Don't say hemiplegia until zero power

[@rahullinton]

So much helpful sir❤❤❤❤

[@anasahmad6749]

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

[@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

[@tarunjha3257]

Kuddos to the presenter calm cool and super intelligent

[@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]

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

[@mohitzambare]

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

[@asfiyafakiha]

Thankyou sir. 😊

[@anasahmad6749]

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

[@anasahmad6749]

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

[@ruhinaresh7410]

Very useful 👍

[@anasahmad6749]

1:16:47 xanthomas etc for metabolic synd,

[@lavanyakumhar8021]

How is this hemiplegia but not hemiparesis

[@anasahmad6749]

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

[@ayushmanmukherjee9297]

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

[@mr.x1363]

V nice 👍

[@medicalknowledge7950]

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

[@sanjujohn6383]

Very good

[@GauravPawar-vl7jb]

In umn distal weakness start first eg in fingers

[@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]

Raised ict in hemorrhagic, or large thrombotic

[@wmaperera]

Well done sir...thanks u..

[@adarshpal4907]

Kadak,🤗🤗

[@krisshhnaa5074]

Don’t be like layman man…

[@shashankgowda2208]

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

[@ViratKohli-yi1xr]

Do we have to know everything like here ?

[@anasahmad6749]

Umn lesion first has distal motor weakness

[@anasahmad6749]

Only lower part of face affected therefore UMN type

[@DrChainSingh]

Thank you sir

[@ravibhoria5563]

Who's the girl presenting the case??

[@ahmadgumman3390]

LMN FACIAL PALSY WILL GIVE YOU IPSILATERAL PALSY??

[@anasahmad6749]

1:44:44 treatment

[@imperialalike1536]

Mangalore 🔥

[@GauravPawar-vl7jb]

Umn type of facial nerve palsy

[@anasahmad6749]

Dense hemiplegia localises to IC

[@drvijayfromkem6934]

Thank you to all

[@anasahmad6749]

1:08:54 pure veg b12 def homocysteiimia

[@anasahmad6749]

Hyper homocysteine

[@anasahmad6749]

Alcohol cocaine smoking Std like hiv may have

[@kirankumarch9954]

I want pdf of this video

[@k.charitachowdary1130]

1:26 speech

[@bhuwansubedi4556]

Menstrual history missing

[@GauravPawar-vl7jb]

Kya karna hai vo leke

[@prantikdas9974]

Woww 🔥

[@dr.vigneshwar5747]

👌

[@kalyanirathod8683]

👏👏

[@goodvibesnerd3228]

What makes blood more coagulable at early morning?

[@aryav1145]

Plaminogen activator inhibitor level is more in early morning

[@drasifpatel1716]

Easy way to remember: Life of PAI begins in the morning!

[@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

[@kishanvishwamitra7727]

Chassignac tubercle

[@sumanthprabhu9319]

Shouldn’t the taste sensation in the anterior 2/3rd on the right half of the tongue be lost?