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.
Text
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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 |
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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 |