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Lateral Medullary Infarction

Q: I am 64 years old and had a non-hemorrhagic infarction in the left half of medulla on 2 months ago. It led to lateral medullary syndrome with associated problems including temperature insensitivity on the right side. I have earlier had hypertension for 15yrs and also been found about a year ago with RBBB. The present treatment includes Pentocid, Depin Retard, Concor 5, ASA 50, Carvideon 20 and SurbexT. I have also developed postural hypertension and my BP goes up in the evening. My questions are as under: a) What specific lifestyle should I adopt with a view to prevent recurrence of the stroke? b) Should I effect changes in medicines to check postural hypertention and rise in BP in the evenings? c) My BP was earlier under control. My vegetarian diet did not include ghee or other fats. I was also undertaking 2-3 kms morning walk everyday and also attending to some household chores. What then could be the possible reasons for the stroke in my case? What more precautions should I take now?

A:You have been rightly diagnosed to have a special type of stroke called Lateral Medullary Infarction. Successful prevention of recurrence of stroke needs identification of modifiable risk factors such as hypertension, diabetes, heart disease (esp. atrial fibrillation), smoking, hyperlipidemia etc. Hypertension has a very strong association with stroke. Reduction of blood pressure within the so called normal range has now been shown to be associated with fewer recurrent strokes. Regular exercise, proper weight management and avoidance of high fat and salt intake is recommended. In case of non vegetarians, red meat should be substituted by white meat, esp. fish. A new antiplatelet drug, Clopidogrel, has been found to be slightly more effective than Aspirin in stroke prevention.

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