Case #16

Final Diagnosis

Larry’s hospital stay is without event. He was transferred to a general medical floor from the step down unit. When he was stable (1-2 months later), he underwent a redo left CEA without problems. His frustration with lack of expressive language is obvious and the therapists report a lack of motivation.
  1. What do you think is at the root of Larry’s lack of motivation?
Sources:

Adams R. Victor M. Ropper A. Principles of Neurology, sixth edition. New York, Mcgraw-Hill Companies, 1997, Chapter 34, pp 777-874.

Albers GW. Bates VE. Clark WM. Bell R. Verro P. Hamiltom SA. Intravenous Tissue-Type Plasminogen Activator for Treatment of Acute Stroke. JAMA. 283:1145-1150, 2000 March.

Becker KJ. Thrombolysis for acute ischemic stroke. Physical Medicine & Rehabilitation Clinics of North America. 10(4):773-85, vii, 1999 Nov.

Andreoli TE. Bennett JC. Carpenter CC. Plum FP. Cecil Essentials of Medicine, Fourth Edition. Philadelphia, W.B. Saunders Company, 1997, Chapter 117, pp.845-873.

Goldstein LB. Carotid endarterectomy for stroke prevention in older people. Clinics in Geriatric Medicine. 15(4):685-700, 1999 Nov.

Novelline RA. Rhea JT. Rao PM. Stuk JL. Helical CT in emergency radiology. Radiology. 213(2):321-39, 1999 Nov.

Weiner HL. Levitt LP. Rae-Grant A. House Officer Series, Neurology, sixth edition. Philadelphia, Lippencott Williams & Wilkins, 1999, Chapter 15, pp 90-108.

Leong/compcase/CVAcase6 10/17/00

Authors: 

Dave Weisman
Class of 2000
Penn State University College of Medicine
Milton S. Hershey Medical Center

Illustrator: 

Cecilia Kim

Faculty reviewers:

Raymond Reichwein, M.D.
Assistance Professor
Neurology

Shou Ling Leong, M.D.
Assistant Professor
Department of Family & Community Medicine
Penn State University College of Medicine

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