James Castle, M.D.

Caring.com Expert

About

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Recently Published on Caring.com

  1. Monday February 06, 2012

    1. is it possible that after a surgery a stroke can make a person completely paralized?

      Answer - I am very sorry to hear about his situation. The unfortunate answer is "yes", a stroke can leave a patient nearly completely paralyzed. It is good that he has some movement on one side, but I would ask his Neurologist to give you a better sense of his overall prognosis. His stroke may be quite severe and debilitating...

    2. Will a RIND stroke show up on an MRI?

      Answer - RIND is a term that isn't used very much anymore. It was an older term that referred to a stroke which resolved somewhere between one day and one week after onset. That said, the answer to your question is "yes". A RIND, by virtue of the fact that it lasts longer than 24 hours, should almost always show up on an MRI as a stroke...

    3. someone help me

      Answer - The first thing to consider is whether or not the patient is safe to swallow all foods. If they have a swallowing dysfunction because of their stroke, you will need to have their physician order a "swallowing study" to make sure that they are safe to eat all consistencies of food. Some patients are only able to eat pureed foods, if at all...

    4. Devices that Help Stroke Patients Living Independently

      Answer - Sorry to hear about her situation. Unfortunately, I am not aware of any such devices, mostly because the "language centers" of the brain that control speech also control reading and writing. Therefore, there may be a comprehension problem that is not fixable.

  2. Wednesday November 02, 2011

    1. After several strokes, my uncle's behavior is inappropriate -- what can we do?

      Answer - Sorry to hear about this.

  3. Tuesday October 04, 2011

    1. Is two minutes of numbness in the toes of right foot sign of stroke?

      Answer - It is hard to say with certainty what this episode represented. It is true that a stroke (or in this case, it would be better defined as a TIA - Transient Ischemic Attack - since it lasted less than 24 hours) can cause numbness to the toes, but that would be a bit unusual. Symptoms of TIA usually last at least 20 minutes...

  4. Friday September 30, 2011

    1. Is it normal to have migraines after a stroke?

      Answer - I have had several patients who get migraine headaches after a stroke. The first thing I always try to do is make sure nothing dangerous is causing the headaches - usually this means getting an MRI of the brain and an MR angiogram of the vessels of the head and neck...

  5. Thursday September 29, 2011

    1. What can I do to ease the right hand "clutching" I'm experiencing after my stroke?

      Answer - Having a tendency to flex the muscles of the hand is very common after a stroke. I would recommend starting by setting up an appointment with a Physiatrist (Physical Medicine and Rehabilitation) doctor. Often, they can do muscle relaxing injections, such as Botox, into those muscles to relieve the strong clenching of the hand...

  6. Monday August 22, 2011

    1. Is confusion normal at night for stroke survivors, and will my father get better in a skilled nursing facility?

      Answer - Sorry to hear of your predicament.

  7. Tuesday August 09, 2011

    1. What should be do prior to calling 911 if my sister has another stroke?

      Answer - The symptoms you describe above do not sound consistent with a stroke. Typically, a stroke would involve weakness or numbness on just one half of the body, often accompanied by visual changes or speech disturbance. If symptoms such as these last longer than 24 hours, and were caused by a stroke, you would expect to see signs of a stroke on an MRI scan...

  8. Friday August 05, 2011

    1. Does vitamin K prevent strokes?

      Answer - You may be overthinking these issues.

  9. Thursday August 04, 2011

    1. Should I be concerned about the minor blood vessel ruptures in my head?

      Answer - There are a few possibilities as to what could cause such an appearance on the MRI. At the age of 60, the most likely would be that you have too high a blood pressure, and that some of the very small arteries in the brain have ruptured over the years...

  10. Friday July 15, 2011

    1. Is moving my husband home after his stroke a good idea, or will he lose all the progress he made in the nursing facility?

      Answer - If he really wants to come home, he probably has a good reason (i.e., he is not getting along with the staff and other residents at the nursing home). I would try your best to help him with this. The easiest way to go about doing this is to ask his physical and occupational therapists how much assistance...

    2. Do we have any other caregiving option for my mom outside of a nursing care facility?

      Answer - Very sorry to hear about this.

  11. Wednesday July 13, 2011

    1. How can I find a stroke doctor that will be willing to make house calls?

      Answer - I am very sorry to hear about your awful situation.

  12. Friday July 01, 2011

    1. What can I do to help treat my husband's post stroke headaches?

      Answer - The first thing I would do is make sure that all necessary imaging has been done. This would include an MRI of the brain and either a CT angiogram or MR angiogram of the vessels of the head and neck. Those would help assure that there is no "mass lesion" causing the pain, and no tear or abnormality of one of the arteries that would cause such pain...

  13. Wednesday June 29, 2011

    1. What is the treatment for post stroke delerium?

      Answer - It does sound very suspicious for post-stroke dementia. Delerium would imply that this is a temporary, reversible issue, which it does not sound like since it has been going on for such a long time. However, I think it is very important to make sure there is no underlying cause for delerium - lab testing...

    2. Is it normal for a stroke survivor to not follow directions?

      Answer - Sorry to hear about this.

  14. Wednesday June 15, 2011

    1. Is it common to have headaches after the stroke has occurred and during recovery?

      Answer - Yes, it is quite common to have headaches from a stroke. Often, the cause of the headache is unclear, but evidence of bleeding at the site of the stroke and/or a problem with one of the arteries that supplies the brain in the area of the stroke should be ruled out by imaging (which she most likely has undergone)...

  15. Tuesday June 14, 2011

    1. Are dad's risk of stroke or complications under anestesia greater than normal?

      Answer - Sorry to hear about your situation.

  16. Saturday June 11, 2011

    1. Is the shaking in my mother's arm caused by the stroke she had?

      Answer - A few things come to mind that might explain the arm shaking:

  17. Thursday June 09, 2011

    1. Why is my father feeling a weird sensation in his leg after a major stroke?

      Answer - This is a fairly common problem after a hemorrhagic stroke. The brain often "makes up" sensations when there is a problem in the regular sensory wiring coming from the arms and legs to the brain. People often describe numbing, burning, pins and needles, or a general sense of discomfort. Often, it starts long after the stroke...

  18. Monday June 06, 2011

    1. After Dad's stroke he became sensitive to light and sound, is there treatment for this?

      Answer - It sounds like he might be suffering from meningeal irritation, or migrainous symptoms. These cause "photophobia" and "phonophobia" - in other words, aversion to light and sound. This may be a result of his stroke. I would talk to his doctor about trying some anti-migraine medication (not acute therapy medicines but preventative medications)...

    2. Is my father having a seizure or a stroke?

      Answer - This is a tricky situation. It is not uncommon for people to suffer from neurological "spells" after a stroke without a clear cut etiology. To a first order approximation, I would guess they are seizures since they come and go without leaving any permanent deficit and have been so stereotyped...

    3. What could be causing mom's tongue to swell?

      Answer - Sorry for this predicament.