Gadama, YG;
Mwangalika, G;
Kinley, LB;
Jackson, B;
Mwandumba, HC;
Mallewa, J;
Solomon, T;
... Phiri, T; + view all
(2017)
Challenges of stroke management in resource-limited settings: A case- based reflection.
Malawi Medical Journal
, 29
(2)
pp. 189-193.
10.4314/mmj.v29i2.21.
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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 rightsided 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.
| Type: | Article |
|---|---|
| Title: | Challenges of stroke management in resource-limited settings: A case- based reflection |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.4314/mmj.v29i2.21 |
| Publisher version: | https://doi.org/10.4314/mmj.v29i2.21 |
| Language: | English |
| Additional information: | © 2017 The College of Medicine and the Medical Association of Malawi. This work is licensed under the Creative Commons Attribution 4.0 International License. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Lab for Molecular Cell Bio MRC-UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10127189 |
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