moya-moya精品课件.ppt

CASE OF THE MONTHSHRAWAN DR MERINA SHRESTHA RESIDENT 3RD YEAR IOM PATIENT’S PROFILE NAME: SHARMILA MAJHI AGE : 6 YEARS/F ADDRESS: MAKAWANPUR DATE OF ADMISSION: 062/4/12 DATE OF DISCHARGE: 062/4/32 ADMITTING DX: ACUTE STROKE SYNDROME FINAL DX MOYA MOYA DISEASE HISTORY OF PRESENT ILLNESS Sudden onset of weakness of left side of the body and deviation of face towards right for 1 day. Mild headache for 4 days. The weakness was non-progressive. No H/O drooling or difficulty in swallowing or speech difficulty No H/O fever, vomiting,ear discharge, sore-throat. No H/O altered sensorium, visual disturbance, loss of consciousness or abnormal movements of the body. HISTORY OF PRESENT ILLNESScontd……… No H/O SOB, palpitation. No H/O bleeding from any site, rash, bone or joint pain or swelling in any part of the body No H/O high colored and decreased urine output. No H/O trauma or any pencil injury. No H/O intake of any medicine. HISTORY OF PAST ILLNESS Similar episode of sudden onset of weakness 5 months back _ Right side of the body. Was admitted at KCH for 2 days and discharged and was referred to Nutritional rehabilitation center. Resolved spontaneously in period of a month and was doing well since then. FAMILY HISTORY Father : 25years/ painlter Mother: 23years/ House-wife Siblings: Elder : 10 years/F Younger: 3years/F No H/ O similar illness/ TB in the family or in close contacts. No H/O consanguinity of marriage. BIRTH HISTORY—FT/S/F/NVD at Home ante-natal/intra-partum or postpartum period: Uneventful IMMUNIZATION HISTORY: Completed according to EPI schedule. DEVELOPMEENTAL HISTORY:Normal for her age NUTRITIONAL HISTORY: Taking less than required calorie (70kc/kg/d). ON EXAMINATION: Child looks comfortable and Alert. Vitals: Pulse: 90/min R/R : 24/min B.P : 90/40 mm Hg Temp: 98.60C No pallor, icterus, rash, lymphadenopathy,edema,