Most thrombotic strokes occur in the distribution of the large cerebral vessels.
Embolic strokes occur in middle-sized vessels, are usually haemorrhagic in nature, and are rarely preceded by transient ischaemic attacks. Maximum deficit is usually present at the onset of the stroke.
Most people are ""deconditioned"", that is, they lack the cardiovascular capacity for optimal health.
We would suggest that this patient be maintained on atenolol 50 mg and nifedipine 30 mg daily, (or prazosin 2-6 mg daily, if required) plus methyldopa up to 1 500 mg daily.
We have sometimes been accused of placing too much emphasis on cardiac medicine.
The full potential of botulinum toxin as a therapeutic agent has yet to be realized.