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Malawi Medical Journal
College of Medicine, University of Malawi and Medical Association of Malawi
ISSN: 1995-7262
Vol. 29, No. 2, 2017, pp. 189-193
Bioline Code: mm17040
Full paper language: English
Document type: Case Report
Document available free of charge

Malawi Medical Journal, Vol. 29, No. 2, 2017, pp. 189-193

 en Challenges of stroke management in resource-limited settings: A case-based reflection
Gadama, Yohane G.; Mwangalika, Gloria; Kinley, Louis B.; Jackson, Beth; Mwandumba, Henry C.; Mallewa, Jane; Solomon, Tom; Simister, Rob; Benjamin, Laura A.; Vargas, Maria I.; Kamtchum-Tatuene, Joseph & Phiri, Tamara

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.

 
© Copyright 2017 - The College of Medicine and the Medical Association of Malawi
Alternative site location: http://revista.uft.edu.br/index.php/jbb/index

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