Fred Black is a 78-year-old man who lives with his wife Joan in a small rural town 60 kilometres south of Adelaide. Both Fred and Joan are independent with 3 children who all live interstate and they see them once or twice a year. Both Fred and Joan are very social and like getting together with their friends. Fred plays bowls three times a week and then joins his friends at the local club for lunch.
Fred was shaving a week ago when he noted that the left side of his face was drooping. His left arm felt very weak, and he tried to call out to Joan, but he could not speak properly. Fred fell to the floor, and Joan found him shortly after and immediately called an ambulance.
Fred was taken to the Emergency Department where on arrival he had a BP of 190/91, HR 115, RR 24, SaO2 95% on room air and a temperature of 37.2. He was immediately sent for a CT head and diagnosed with a CVA.
Fred’s past medical history includes hypertension, hypercholesterolemia, Diabetes Mellitus, GORD, Atrial Fibrillation and a cholecystectomy 5 years ago.
Fred was transferred to the neurological ward. On assessment he had a GCS of 13, left sided hemiplaegia, expressive dysphasia, dysphagia & blurred vision in his left eye. He was scheduled to see the speech pathologist and the physiotherapist.
***Discuss the pathophysiology of Diabetes as the most likely cause of freds CVA****
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