Animesh Das* and E Satheesh Kumar

Department of Pharmacy Practice RR College of Pharmacy Chikkabanavara, Bangalore, 560090, Karnataka, India

*Corresponding Author: Animesh Das, Department of Pharmacy Practice RR College of Pharmacy Chikkabanavara, Bangalore, 560090, Karnataka, India.

Received: December 18, 2025; Published: December 26, 2025

Abstract

This case describes a patient who developed an acute stroke in the presence of several health problems. Sudden onset of dizziness followed by a fall with head injury. After this, he developed slurred speech, weakness of the left arm, and deviation of the mouth to the left. Symptoms appeared suddenly, did not progress, and there was no loss of consciousness. He was admitted to the neurology department for evaluation. On admission, investigations showed haemoglobin 13.2 g/dL, white blood cell count 9200, and platelets 3.19 lakh. However, blood clotting studies showed increased prothrombin time of 16.3 and INR of 12.6 on some days, indicating delayed clotting. His medical history revealed hypertension for five years, type 2 diabetes mellitus, and ischemic heart disease for ten years. He had undergone coronary angioplasty earlier and was taking medicines like enalapril, metformin, glimepiride, atorvastatin, and clopidogrel. He had quit smoking ten years ago after smoking 5–10 cigarettes daily for 15 years. He did not consume alcohol. During admission, he was treated conservatively as advised by neurosurgery, cardiology, and ophthalmology teams. Antiplatelet medicines were stopped due to the presence of intracranial bleeding. He received intravenous antibiotics (ceftriaxone), stomach protection (pantoprazole), an antiemetic (ondansetron), mannitol to reduce brain swelling, vitamin injections, and insulin for blood sugar control. Other medicines included bisoprolol, enalapril, atorvastatin, modafinil, and baclofen. Supportive care included physiotherapy for limb and speech recovery, restricted salt intake below 2 g/day, and limited fluid intake below 1.2 L/day. This case highlights the role of careful conservative management and the importance of long-term rehabilitation in a patient with multiple risk factors such as hypertension, diabetes, and heart disease.

Keywords:Ischemic Stroke; Hypertension; Coronary Angioplasty; Diabetes Mellitus

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Citation

Citation: Animesh Das and E Satheesh Kumar. “Complex Presentation of Acute Ischemic Stroke with Small Haemorrhagic Foci and Cranial Nerve Involvement in the Background of Diabetes, Hypertension, and Ischemic Heart Disease".Acta Scientific Neurology 9.1 (2026): 21-26.

Copyright

Copyright: © 2026 Animesh Das and E Satheesh Kumar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.