Challenges of stroke management in resource-limited settings : A case-based reflection
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2017 |
|---|---|
| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
|---|---|
| Enthalten in: |
Malawi medical journal : the journal of Medical Association of Malawi - 29(2017), 2 vom: 28. Juni, Seite 189-193 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Gadama, Yohane G [VerfasserIn] |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 04.01.2018 Date Revised 09.01.2021 published: Print Citation Status MEDLINE |
|---|
| Förderinstitution / Projekttitel: |
|
|---|
| PPN (Katalog-ID): |
NLM276253876 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM276253876 | ||
| 003 | DE-627 | ||
| 005 | 20231225011605.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2017 xx |||||o 00| ||eng c | ||
| 028 | 5 | 2 | |a pubmed24n0920.xml |
| 035 | |a (DE-627)NLM276253876 | ||
| 035 | |a (NLM)28955431 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Gadama, Yohane G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Challenges of stroke management in resource-limited settings |b A case-based reflection |
| 264 | 1 | |c 2017 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.01.2018 | ||
| 500 | |a Date Revised 09.01.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Mwangalika, Gloria |e verfasserin |4 aut | |
| 700 | 1 | |a Kinley, Louis B |e verfasserin |4 aut | |
| 700 | 1 | |a Jackson, Beth |e verfasserin |4 aut | |
| 700 | 1 | |a Mwandumba, Henry C |e verfasserin |4 aut | |
| 700 | 1 | |a Mallewa, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Solomon, Tom |e verfasserin |4 aut | |
| 700 | 1 | |a Simister, Rob |e verfasserin |4 aut | |
| 700 | 1 | |a Benjamin, Laura A |e verfasserin |4 aut | |
| 700 | 1 | |a Vargas, Maria I |e verfasserin |4 aut | |
| 700 | 1 | |a Kamtchum-Tatuene, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Phiri, Tamara |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Malawi medical journal : the journal of Medical Association of Malawi |d 1991 |g 29(2017), 2 vom: 28. Juni, Seite 189-193 |w (DE-627)NLM094421811 |x 1995-7270 |7 nnns |
| 773 | 1 | 8 | |g volume:29 |g year:2017 |g number:2 |g day:28 |g month:06 |g pages:189-193 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 29 |j 2017 |e 2 |b 28 |c 06 |h 189-193 | ||