Javier Nasta - Sequelae of cerebral infarction (Uruguay) Posted on January 6, 2014

Name:Javier Nasta 


Age:52 years old

Country: Uruguay
Diagnose:Sequelae of cerebral infarction

Admission Date: 2013-11-01

Days Admitted to the Hospital:28

Before treatment:

The patient suffered from slobbering of right side without inducement 3 and a half years go. The patient suffered from movement disorders of right limbs. He also had speech disorders. There was no dizziness, headache, vomit or nausea. There was no rotation when observed. The patient had a good. He went to a local hospital for therapy and received related examination and therapy. The lipoprotein was increased obviously. The CT of head showed there was change of cerebral infarction. The patient's condition tends to be stable when he in hospital but acroparalysis of the right limbs and speech disorders had no obvious improvement. Despite this, the patient insisted on taking medication and rehabilitation. The patient's muscle strength of the right limbs had increased 1 year ago. He could communicate with family members simply. But he still can utter fewer words. From the onset of the disease, the patient's spirit was good and his appetite was also good. The sleep quality was poor; the weight had no obvious change. The patient couldn't take care of himself before the treatment, so he came to our hospital for further therapy.

Admission PE:
Bp: 116/80mmHg; Hr: 55/min. Temperature: 36.2 degrees. The nutrition was normal. The skin and mucosa was intact, with no stained yellow or petechia. He had hemiplegic gait. The respiratory sounds in both lungs were clear, with no dry or moist rales. The cardiac rhythm was regular, with no obvious murmur in the valves. The heart sounds were low. The abdomen was expanded, with no pressing pain. The liver and spleen were not palpable. There was mild pitting edema, and the right side was more severe. The temperature of the right lower limb extremity was slightly low.

Nervous System Examination:
Javier Nasta was alert, and in weak spirits. He showed a slow response. The examination of memory, calculation, comprehension and orientation were slow than normal. His speech was unclear. This accompanied with aphasia. He had anomie aphasia. He had strong muscles to close the eyes. Both pupils were equally rounded; the diameter was about 3.0mm. Both eyeballs were sensitive to light stimulus. Both eyeballs movement to each side was almost normal through loose measurement. There was slight horizontal nystagmus. His right vision was defective partly. He had strong chewing muscles. The tongue was skewed to the right side. The corner of mouth was shifted to the left side when he grinned. The uvula was shifted to the right side. The muscles at the right shoulder were weak and unable to shrug the shoulder. The muscle strength of the right upper limb near-end was at level 2 and the far end was at level 3. The grasp power of right hand was at level 2. The muscle strength of right lower limb was at level 3+. The muscle strength of left limbs was at level 5. The muscle tone was higher than normal when he bends the right upper limb. The muscle tone of right shoulder was slightly higher than normal too. The right abdominal reflexes were not elicited. Right limbs tendon reflex was active slightly. Right wrist joint had clonus. Right palm jaw reflex was positive. Right side Hoffmann sign was positive. Right side Babinski sign was positive.  Right side presented with hemihypalgesia. Right side tuning fork vibration sense was slow down and the far end was severe. The left side tuning fork vibration sense was normal. Right side joint position sense, graphic positioning sense and fine sense were slow. Right side was unable to finish the finger-to-nose test or the rapid rotation test. There were no signs of meningeal irritation.

Javier Nasta received all relevant examinations. The patient received nerve regeneration treatment and stem cell activating treatment. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and also to nourish the neurons. He also received treatment to stable the blood pressure, heart rate and cardiac function. This was combined with physical rehabilitation training.

Post treatment:
The patient's spirit and mood are stable. The diet and sleep is good. The muscle tone of the right shoulder is slightly reduced. The muscle strength of his right side has increased slightly and he shrugs his shoulder now. The dislocation of right shoulder is almost corrected. Right knee can be bent more easily when he walks. And the walking posture is better. The grasp power of the right hand has increased to level 3. The muscle strength of the right lower limb has reached level 4. Right foot has plantar flexion. Right side hemihypalgesia sign is no more severe and the senses have attained a certain degree of recovery.  The skin temperature of the right side has also almost returned to normal. The patient has gained more autonomous language. He has more communication with family members than before. The slobbering has almost disappeared. The position of tongue at corners is better than before. The uvula is almost at the center in the oral mouth. The calculation, comprehension and reaction ability are better than before.


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Email from Javier's wife:

Date: 2013-12-12

Estimada  doctora:

Nuestros saludos para todo el equipo delantero clinica.

Queria hacerles saber que mi esposo va  marchando bien, ya reanud sus terapias y se continan notando avances enlaces parte  motora y  linguisticas.  Continua afinando sus movimientos  en la marcha y en el uso del brazo y mano aunque todavia lo hace solo a requerimiento.  El habla ha mejorado, intenta  pedir las cosas hablando o armar frases.  En los calculos , comenzo ayer  a multiplicar y dividir entre 2, muy sencillo.

The follwing are translate from Spanish:

Dear Doctor

Our greetings to all the team striker clinic

I wanted to let you know that my husband is going well, it resumed its therapies continue to progress and noticing part motor and linguistic links Continues to refine their movements on the March and in the use of arm and hand while still just a requirement The spoke has improved, try to ask the things or make sentences In the calculations, began yesterday to multiply and divide by 2, very simple

Date: 2014-02-20

Estimada doctora:
Le  adjunto los  analisis de mi  esposo realizados  despues  de una  semana  de la  modificación en la  medicació n  tal   como  lo indicó el doctor.
Javier  sigue  avanzando  ya  habla  un poco  mas.
Mi preocupacion son los medicamentos  ya que  quedan muy  pocos  de los que  no  consigo  acá. Recuerde  que  le  mandé la lista  en el mail  anterior. Mandeme el importe y se lo  giramos a  la  brevedad.
Saludos y muchas gracias.  Monica

 Date: 2014-06-06
Estimada doctora:
     Han pasado ya los 6 meses  del implante que se le realizo a mi esposo. El se encuentra bien, con energia, buen humor. Continua con sus terapias diarias y sus caminatas;  el movimiento espontaneo del brazo no lo ha logrado, solo lo usa en las terapias.
     El habla es solo a requerimiento, es escasa y con dificultad.
      Queria saber si tiene que continuar con toda la medicacion  o si debe dejar las correspondientes al crecimiento de las celulas madre.
     Por favor,me gustaria que me contestara esto especificamente y si ustedes consideran necesario que volvamos a realizar otro implante.
      Muchas gracias y saludos.
   Monica Meyer.


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