内囊(IC)是一个重要的大脑结构,容纳下降和上升的纤维束,关于皮质球束和皮质脊髓束通过内囊后肢(PLIC)的前肢和前肢的前三分之一下降的传统假设,分别。然而,对IC梗死的观察表明,症状经常偏离预期的纤维模式,促使人们更深入地探索这些复杂性。IC的后肢从大脑中动脉和脉络膜前动脉(AChA)的豆状条纹分支接受血液供应。AChA梗塞除了经典的三合会外,还有各种各样的症状,反映了该区域内复杂的血管供应和病变模式。我们介绍了一个74岁的男性农民右手占优势的案例,跌倒导致头部和右下肢受伤。随后,他的左上肢和下肢出现了无力,面部偏差,含糊不清的讲话,右下肢肿胀.在这些症状之后,他的家人于2023年11月30日迅速将他送往医院。广泛的调查,包括磁共振成像(MRI),显示左IC后肢有超急性梗塞。病人入住重症监护病房(ICU)三天,随后转移至神经科病房,开始进行医疗管理,包括2023年12月2日开始的物理治疗方案。物理治疗干预旨在解决患者的弱点,改变的感觉,和减少的反应。治疗目标集中在预防并发症,改善姿势,增强运动范围(ROM),减轻呼吸困难和行动不便的问题。物理治疗旨在提高患者的整体身心健康,强调独立和提高生活质量。根据患者的进展情况,定期评估和调整治疗干预措施。该病例强调了量身定制的物理治疗干预措施在解决IC梗塞的各种表现方面的重要性。有助于全面了解神经系统受损个体的康复策略。
The internal capsule (IC) is a vital brain structure housing descending and ascending fiber tracts, with traditional assumptions about the corticobulbar and corticospinal tracts descending through the genu and anterior third of the posterior limb of internal capsule (PLIC), respectively. However, observations of IC infarctions reveal that symptoms often deviate from the expected fiber pattern, prompting a deeper exploration of these complexities. The posterior limb of the IC receives its blood supply from the lenticulostriate branches of the middle cerebral artery and the anterior choroidal artery (AChA). AChA infarctions present a diverse array of symptoms beyond the classic triad, reflecting the intricate vascular supply and lesion patterns within this region. We present a
case of a 74-year-old male farmer with right-hand dominance, who experienced a fall resulting in head and right lower limb injuries. Subsequently, he developed weakness in his left upper and lower limbs, facial deviation, slurred speech, and swelling in the right lower limb. Following these symptoms, his family promptly brought him to the hospital on November 30, 2023. Extensive investigations, including magnetic resonance imaging (MRI), revealed a hyper-acute infarct in the posterior limb of the left IC. The patient was admitted to the intensive care unit (ICU) for three days and later shifted to the neurology ward where medical management was commenced, including physiotherapy protocol that was started on December 2, 2023. Physiotherapy interventions were designed to address the patient\'s weakness, altered sensation, and diminished reflexes. Therapeutic goals focused on preventing complications, improving posture, enhancing range of motion (ROM), and mitigating breathing difficulties and mobility issues. The physiotherapy aimed to enhance the patient\'s overall physical and mental well-being, emphasizing independence and improved quality of life. Regular assessments and adjustments to the therapeutic interventions were made based on the patient\'s progress. This
case underscores the importance of tailored physiotherapy interventions in addressing the diverse manifestations of IC infarctions, contributing to a comprehensive understanding of rehabilitation strategies in neurologically compromised individuals.