A 70-year-old man with diabetes presented with slurred speech and altered behavior lasting 30 minutes. He was diagnosed with a transient ischemic attack caused by low blood sugar. Tests showed high HbA1c and cholesterol. An MRI showed age-related brain atrophy and ischemic lesions. He was admitted, prescribed medications including aspirin and antidiabetic drugs, and counseled on diet and blood sugar control to prevent future attacks.
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TIA
1. A CASE STUDY ON TRANSIENT ISHEMIC
SHOCK
PRESENTED BY : UNDER THE GUIDELINES OF:
D.PRIYA CHANDANA RANAKISHORE
III PHARM.D
19AB1T0022
VIGNANA PHARMACY COLLEGE
(Approved by AICET , PCI – new delhi and affliated to JNTUK)
Vadlamudi, Guntur dist , Pin.code : 522213
2. INTRODUCTION OF TRANSIENT
ISCHEMIC ATTACK
• DEFINITION : A trans ient ischemic attack [ tia ] or mini strock is caused by
a temporary disruption in the blood supply to part of the brain . The
distruption in blood supply results in a lack of oxygen to the brain
• ETIOLOGY : smoking
high blood pressure
obesity
high cholestrol level
alcohol
diabeties
arterial fibrillation
3. PATHOPHYSIOLOGY : A TIA characterised by temporary reduction reduction of blood
flow in a neurovascular distribution as a result as a result of partial or total
occlusion – typically from a thromboembolic event or stenosis of vessels
• Clinical manifestation would depend on the cerebral territory involved
RISK FACTORS : HTN
DM
smoking
previous strock
previous tia
cardiac arrthymias
obesity
oral contaceptive pills
SIGNS AND SYMPTOMS : face – face droop /assymetry
arms – arms drift / arm weakness , numbness
specch – slurring of speech
4. • DIAGNOSIS : COMPLETE BLOOD COUNT
a fingerstick blood glucose for hypoglycemia
serum electrolyte levels
coagulation studies
ECG
MRI
carotid doppler ultrasonography of the neck
CT angiography
MRA
TREATMENT : ANTI PLATELET DRUGS
ANTI COAGULANTS
SURGERIES : ANGIOPLASTY
5. PATIENT DETAILS
• NAME : XXX
• AGE : 70 YRS
• SEX : MALE
• IP NO : IPGN221000184
• UMR NO : GN-221000412
6. SUBJECTIVE
• C/O : slurring of speech , altered behaviour
lasting for 30 min at around 2: 30 on 7-10-
22.light upper lower limb weakness no 4/0
headache seizures or loss of conciousness
jency moviements bowel and bladder
incontinence
7. OBJECTIVE
• Past medical history : Diabetes
• Past surgical history: nill
• Past trauma history : nill
• Social history : nill
• Family history : nill
• Surgeries : nill
9. LAB INVESTIGATIONS
HbA1C 7.7%
NONDIABETIC LEVEL 4.3 -
6.3%
DIABETIC CONTROL 6.4-
7.9%
POOR CONTROL 8.0 – 9.0
%
POST PRANDIAL BLOOD
SUGAR
189 MG / DL
NON DIABETIC 60-
140MG/DL
PRE DIABETIC 140-200
DIABETIC >200MG/DL
10. MRI
IMPRESSION :
• age related atrophic changes as described [
lose brain leiis [ neurons] and connections
increases between brain cells and brain vol
decreases]
• Periventricular ischemic with ischemic foci as
described [ ischemic in ventricules of brain]
18. ASSESMENT
• A 70 years old male patient known case of
diabetic normotensive came to hospital with
c/o slurring of speech altered behaviour
lasting for 30 min at around 2:30 on 7/10/22
with blood sugar levels 69mg / dl was
dignosed with transient ischemic attack
,neuroglycopenia
19. PLAN
• Hospitalisation
• Mri brain
• Monitoring blood sugar
• Salt restricted diabetic diet
• Avoid hypo/hyperglycemia
20. DRUG DOSE ROA FREQUENCY
INJ PANTOP 40MG IV OD
INJ OPTINEURON 1AMP IV OD
TAB.PANTOP 40MG P/O OD
TAB.ROSUVAS 40MG P/O HS
TAB.ASPRIN 75MG P/O OD
TAB.CLOPITAB CV 75MG/20MG P/O OD
SYP CREMAFFIN 75ML P/O OD
TAB GLYCOMET GP4
FORTE
4/1000MG P/O BID
TAB NEX CD3 50/500MG P/O OD
REJUNEX CD3 1 PO OD