How to treat a cerebral infarction related with an event?

Question

Hi doctor,

My 21-year-old sister got cerebral infarction because she talked to her father after 15 years, and big emotions were involved. One of her eye pupils became larger, and she could not see correctly. The doctor has done computed tomography (CT) and confirmed it was cerebral infarction. She is already fine for the moment, but I am seeking for a second opinion. Will this affect her in the future? What should be avoided? It happened for the first time. She takes medication for asthma and allergy, but not regularly.

Answer 1

Hello,

Welcome to icliniq.com. As you mention that your 21-year-old sister had cerebral infarction, she needs a complete evaluation to know the etiology of a stroke at the young age of 21 (young stroke). As you say, her pupil became large, and she could not see properly; such symptoms may suggest the involvement of the optic nerve. It is usually very difficult to diagnose by CT (computed tomography) scan and may need an MRI(magnetic resonance imaging) scan of the brain. I would suggest you send all reports to diagnose the problem and plan further treatment. If she has confirmed cerebral infarction, she needs to be on regular blood thinners (antiplatelets or anticoagulants) and avoid oral contraceptive medications, especially estrogens. The probable cause is still need further evaluation. The investigations to be done are magnetic resonance imaging (MRI) brain and orbits with contrast, also may need MRI spine with contrast, visual evoked potential, somatosensory evoked potential, ANA (antinuclear antibody), anti-dsDNA (anti-double stranded DNA), C-ANCA (cytoplasmic anti-neutrophil cytoplasmic antibody), P-ANCA (perinuclear anti-neutrophil cytoplasmic antibody). The differential diagnosis include 1. Optic neuritis (cause to be looked for). 2. AION - acute ischemic optic neuropathy. The probable diagnosis is optic neuritis (optic nerve inflammation).