shanamarie
Guru
Hoping someone can help w/ this. Would a Lacunar infarct even though it was found in 2022 be high for problems? Also w/ the below notation would you consider this high risk?
She is here today for evaluation of prior stroke. She did undergo MRI imaging of the brain in 2020 which showed a small area of encephalomalacia in the right occipital lobe. She underwent repeat imaging in 2022 which showed small chronic lacunar infarctions in the right peritrigonal and left putamen regions along with encephalomalacia in the right occipital lobe.
IMPRESSION:
1. Ischemic stroke: She has multiple stroke risk factors including hypertension, hyperlipidemia and tobacco abuse. She has undergone cardiac monitoring with no signs of atrial fibrillation. She is no longer taking medication for hypertension or hyperlipidemia. At today's clinic visit we did discuss her imaging findings along with her modifiable stroke risk factors. I encouraged her to follow up closely with primary care physician for monitoring and management of her stroke risk factors.
2. Hypertension: At today's clinic visit her blood pressure was noted to be 220/100. This was rechecked on several occasions. She does visit in several hours with primary care physician is going to discuss further management.
PLAN:
Recommend aggressive secondary stroke risk factor management including tobacco cessation, treatment of hypertension and hyperlipidemia.
Daily aspirin
She is here today for evaluation of prior stroke. She did undergo MRI imaging of the brain in 2020 which showed a small area of encephalomalacia in the right occipital lobe. She underwent repeat imaging in 2022 which showed small chronic lacunar infarctions in the right peritrigonal and left putamen regions along with encephalomalacia in the right occipital lobe.
IMPRESSION:
1. Ischemic stroke: She has multiple stroke risk factors including hypertension, hyperlipidemia and tobacco abuse. She has undergone cardiac monitoring with no signs of atrial fibrillation. She is no longer taking medication for hypertension or hyperlipidemia. At today's clinic visit we did discuss her imaging findings along with her modifiable stroke risk factors. I encouraged her to follow up closely with primary care physician for monitoring and management of her stroke risk factors.
2. Hypertension: At today's clinic visit her blood pressure was noted to be 220/100. This was rechecked on several occasions. She does visit in several hours with primary care physician is going to discuss further management.
PLAN:
Recommend aggressive secondary stroke risk factor management including tobacco cessation, treatment of hypertension and hyperlipidemia.
Daily aspirin