Challenges of stroke management in resource-limited settings: A case- based reflection



Gadama, Yohane G, Mwangalika, Gloria, Kinley, Louis B, Jackson, Beth, Mwandumba, Henry C, Mallewa, Jane, Solomon, Tom ORCID: 0000-0001-7266-6547, Simister, Rob, Benjamin, Laura A ORCID: 0000-0002-9685-1664, Vargas, Maria I
et al (show 2 more authors) (2017) Challenges of stroke management in resource-limited settings: A case- based reflection. MALAWI MEDICAL JOURNAL, 29 (2). pp. 189-193.

[img] Text
Challenges of stroke management in resource-limited settings: A case-based reflection.pdf - Published version

Download (689kB)

Abstract

A 19-year-old man presented with a 1-year history of headache, generalised body weakness, progressive memory loss, and disorientation. One month prior to admission, there was aggravation of the weakness of the right upper limb, with new-onset difficulty with mastication, speech impairment, apathy, and urinary incontinence. On clinical examination, the patient had a motor aphasia and a right-sided hemiparesis with increased muscle tone and hyperreflexia. A noncontrast computed tomography (CT) scan of the brain revealed large ischaemic strokes extending beyond the classical vascular territories. Cerebrospinal fluid analysis showed a mildly increased protein level. The electrocardiogram revealed an irregular sinus bradycardia. The remainder of the cardiovascular and laboratory workup was unremarkable. Considering a working diagnosis of central nervous system vasculitis, the patient was treated with aspirin, prednisolone, and physiotherapy. However, he died suddenly a few weeks later. Based on this case, we discuss the challenges of stroke management in resource-limited settings, provide practical tips for general practitioners, reflect on the potential avenues for short- and long-term action, and introduce the budding collaboration platform between the University College London, the University of Liverpool, the Queen Elizabeth Central Hospital, and the Malawi-Liverpool-Wellcome Trust Clinical Research Programme.

Item Type: Article
Uncontrolled Keywords: Humans, Muscle Weakness, Headache, Male, Stroke, Young Adult
Depositing User: Symplectic Admin
Date Deposited: 21 Feb 2018 12:21
Last Modified: 19 Jan 2023 06:39
DOI: 10.4314/mmj.v29i2.21
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3018279