These are some of the notes from the Disability exam: 12/12/08 MRI of the brain and skull reported craniectomy changes of the posterior fossa; extensive areas of infarction of the cerebellar hemispheres in the PICA distribution as well as the pons and middle cerebellar penduncles. 4/23/09 VA neurology note: noted to have mild nystagmus on lateral gaze and mild 6th cranial nerve palsy with slight left facial droop. 1/6/11 DIAGNOSES: Stroke, affecting the bilateral cerebellum and pons, due to dissected vertebral artery, with the residuals of: fatiguing, mild dysphagia, mild aphasia, left hemiparesis with mild weakness and fatiguing and lack of endurance of left extremities, episodic tremors, episodic dizziness, headache from occipital muscle tension headaches, intermittent tinnitus. Although there is no evidence of damage to cranial nerve VI nor VII per se; the veteran has had damage to the pons, the area where the cranial nerves originate, the dizziness and tinnitus are consistent with inappropriate processing of signal coming from the labyrinth and cochlea along CN VIII to the areas of the brain damaged in the strokes.
Tomorrow I will preach the funeral for a dear friend of mine. He was the definition of a selfless person. I truly appreciated all that he did, but, when I was meeting with the family on Wednesday a memory came to me suddenly and I was suddenly overcome with emotion. Let me back up a little bit: After my stroke in December, 2008 my license was revoked for obvious reasons and it took me some time and practice before I was able to drive again. I finally got my license back in February, 2009. But, shortly after I got my license back the reality of the severity of my stroke became evident: my stroke had seriously impacted the PONS area of my brain stem, and therefore, a lot of my nerves were negatively impacted. One of the nerves that was damaged was the nerve that controls my eye movements; my left eye would would twitch, at times almost uncontrollably, and that made it really difficult to drive, particularly at night. That brings me to the memory that left me so emotional. Fast forwar
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