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My dad recently had a stroke about 3 weeks ago. He was

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My dad recently had...

My dad recently had a stroke about 3 weeks ago. He was cleared by a neurologist who said he has no brain damage. the past 3 days he has been walking up and down the stairs of our apartment building all hours of the day saying he's looking for something. Today he did not realize he had two shirts on and two shorts on. I'm very concerned because this is not normal behavior. His primary says we need to see a neurologist asap but i have not been able to get him an appointment soon enough. Im wondering if this behavior could have anything to do with the stroke he suffered a few weeks ago

Doctor's Assistant: Do you keep personal medical records to help track this?

Yes

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

He had a heart attack the same day he had the stroke. He has a history of pancreatitis

Submitted: 2 months ago.Category: Neurology
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Answered in 4 hours by:
3/31/2018
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 2 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,265
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns related to your dad.

I am sorry to hear about your dad’s health as you have described above. As a Neurologist I frequently diagnose & treat this type of health situation, and I can certainly help you in this regard.

I can fully understand your concerns considering this is a totally new behaviour for him

You are also wondering whether this is related to the stroke he had sustained about 3 weeks ago, or could it be something else

Please see, this appears most likely a new health situation rather than something related to the stroke he had sustained about 3 weeks ago

This is because stroke is expected to cause maximum symptoms or most of the symptoms during or just after the stroke, say for the first few days after the stroke, afterwards as the swelling & irritation in the brain subsides the symptoms either remain stable or parallely improve too.

But in his case new symptoms are appearing now for the past 3 days or so, if this were due to his previous stroke then these type of new behavioural symptoms should have started occurring during or just after the stroke as mentioned earlier above, this type of about approximately 2.5 week gap indicates this is most likely something new

The type of new behavioural symptoms he has been now having can also be described as new onset confusion & memory loss because - for example he has forgotten (so implies memory loss) that he had already worn his shirts and shorts, but then wearing another pair despite already on the initial pair indicates there is confusion too.

Similarly the repeated walking up and down the stairs to apparently look for something also indicates he is forgetful and also confused too

This type of new behavioural change in someone who has had a stroke recently raises the suspicion for new stroke

This is especially so because he also has had a heart attack recently and heart attack may also increase the risk for stroke and recurrent strokes

There are certain kinds of strokes that present with confusion and memory loss such as this one - instead of presenting with the more typical stroke symptoms such as motor paralysis, speech difficulties or facial droop, or loss of sensation or other motor or sensory symptoms, rather strokes can manifest with new onset behavioural changes like this too

Strokes involving a part of the brain called as parietal lobe can present like this

This is especially so if the right parietal lobe is affected

In right handed individuals it is most often the right parietal lobe that is most often involved, and in left handed individuals too it is still right sided parietal lobe stroke most often, but in them sometimes left parietal lobe stroke too can do this.

Certain medical conditions such as electrolyte disturbances or infections or if any new medications were started then such medication side effect too can cause these types of new symptoms.

I see immediate appointment with his neurologist is not available

Under these circumstances it is actually better if he could be taken to the er for further evaluation and management

Since there is a suspicion for a new stroke so visiting the er instead of waiting for the neurology clinic appointment is considered as the most appropriate approach now

In the er he will receive a thorough neurological examination, followed by certain relevant neurological & medical investigations too such as blood tests to check for electrolytes, any new onset infection etc because as mentioned earlier such conditions too can cause such new symptoms, and then a brain scan too to rule out the possibility of new onset stroke and then treated appropriately depending upon the test results. And in many er they also have neurology on call coverage so he can receive a thorough evaluation by a neurologist too.

To summarize once again;

Yes I fully concur with you, your concerns are very valid since your dad is having now new onset symptoms, and these are occurring after several days gap from the stroke he has had about 3 weeks ago, so due to this time gap we need to explore various new possibilities such as the ones that are mentioned earlier above, so in this regard it is better if he is taken to the er for a faster evaluation and investigations instead of waiting for his neurology clinic appointment, so that a final precise diagnosis can be made & also appropriate treatments can be instituted at the earliest.

Wishing your dad a quick & complete recovery!

Wishing you guys the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further.

Can I let the system release the rating scale, and could you take a moment and kindly click a positive rating to credit for the time & effort put by me in answering your health question? And this is the only way I will be credited for my service to you. Rating me now will not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Kindly let me know

Assuring you guys the best services!

Best Regards!

Dr Subbanna MD

For future questions you can follow up either here, or you can reach me directly with "a question for Dr Subbanna MD" through my Just Answer direct link mentioned below here;

http://www.justanswer.com/medical/expert-drsubbannamd

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 2 months ago

Hi, how is your dad doing now? Was any decision taken to show him in the er? I hope he is doing better now.

Was the information I had provided earlier helpful to you? Do you want to discuss further about his health situation? Or any other health concerns?

Please let me know.

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