Tiêu đề STROKE | CNS & CRANIAL NERVE EXAMINATION ✅

LONG CASES STROKE Ref: Davidson 23rd edition, pg 1148 - 1162 Guide to the essentials in Emergency Medicine, 2nd edition, Shirley Ooi CASE References Case 57 yrs old Malay gentleman, Nkmi, a non-smoker who works as a taxi driver presented with 1 day history of right-sided body weakness. No other asscociated sx. Pe: UL hypertonia, hyperreflexia, power 0/5 LL hypertonia, hyperreflexia, power 3/5 Question 1. How progressive is the sx, is there worsening? Stroke: Rapidly reaches maximum severity Stroke mimics: Often gradual onset 2. What is the nearest facility? How far? Social history- Are there any stairs at his house? This is based on patient’s answer. 4. Tell me the grading for the power? Based on PE results. (0/ 5 and 3/ 5 on the UL and LL respectively) 5. What else you want to look for general ex for this patient?
6. What are etiology of stroke? 7. Risk factor of this patient? According to the scenario, patient has no risk factor. These are the risk factors listed in Davidson textbook. 8. For this patient without any risk factor, what do you think the cause? I think here we should answer that we would like to perform investigation for instance CT brain to look for the pathology so we can proceed to the subsequent questions.
9. How do you differentiate ischemic and hemorrhagic based on clinical & CT?
10. The patient came with this presentation, CT scan was normal, do you think it is a stroke or not & why? It could be lacunar syndrome (LACS) which involve the thrombotic occlusion of small perforating arteries (Thrombosis in situ). This is proven by the presence of pure motor stroke effect and the absence of higher cerebral dysfunction or hemianopia.