85 year old male

85 year old male came to casualty with chief complaints of weakness of left upperlimb and lowerlimb since 15 days
Difficulty in swallowing since 15 days 
Deviation of mouth towards left side since 15 days
No h/o of involuntary micturation
No history of involuntary defecation
K/C/O HTN and on medication

On examination :
Patient conscious , coherant , cooperative 
Past history : Hypertensive and on medication
No relevant family and personal history
Temperature : afebrile
Pulse rate: 100/ min
Blood pressure : 140/90 mmhg
Respiratory rate : 22 cycles per min
SPO2 :99 % at room air
GRBS: 198 mg/dl
CVS : S1 and S2 heard 
Respiratory system : NVBS present , BAE present
CNS :
Conscious 
speech - normal
no signs of meningeal irritation
Tone :Increased  in left side
power:      Right.         left
                    4+/5.        4+/5
Reflexes :
                       Right.              left
Biceps:.         +.                     +++
Triceps:.        +.                      +++

Gait         
Supinator:.    +.                      +++
Knee :            +.                      ++
Ankle:.            +.                     +
left extensor  present( babniski positive)

provisional 
Diagnosis: CVA with   left Umn palsy with 
Acute infarct 
in Right Parietal lobe and Frontoparietal lobe
Investigations :
Treatment given :

RT FEEDS 100 ML MILK - 2ND HOURLY , 100ML HOURLY
2) INJ  PAN 40 MG /IV/OD
3) INJ OPTINEURON 1 AMP IN 100 ML NS /IV/OVER 30 MIN
4)TAB ASPIRIN 100 MG RT/OD
5)TAB CLOPIDOGREL 75 MG RT /OD/H/S
6) TAB ATORVASTATIN 40 MG /RT/OD/HS


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