CNS Long Case (UKM)

Question 1

State the risk factors of stroke

Answer 1

• Hypertension
• Diabetes
• Dyslipidemia
• Conditions that predispose embolism: cardiac arrhythmias, IE, congenital heart disease (ASD, VSD), prosthetic heart valve
• Aortic stenosis
• Hypercoagulability/thrombophilic disorder
• Explore causes of young stroke in young patient

Question 2

State other causes of hemiparesis

Answer 2

• Space-occupying lesion
• Trauma: especially SUBDURAL HEMATOMA
• Cervical cord lesion: CERVICAL SPONDYLOSIS

Question 3

What are the complications of stroke?

Answer 3

• Functional status: locomotion
• Speech
• Swallowing, nutritional status
• Bladder dysfunction: neurogenic bladder, frequent UTI
• Aspiration pneumonia
• Pressure sore
• DVT due to prolonged immobilization
• Vascular dementia
• Seizure

Question 4

List the signs/symptoms of left MCA

Answer 4

• Aphasia (BROCA/WERNICKE AREA)
  1. Expressive aphasia (superior division)
  2. Receptive aphasia (inferior division)
• Right-sided sensory loss (LEFT PARIETAL CORTEX)
• Right-sided weakness (LEFT FRONTAL CORTEX)
• Eye deviation to the left (LEFT FRONTAL EYELID)
• Right inferior quadrantonopia

Question 5

List the signs/symptoms of right MCA

Answer 5

• Neglect syndrome
• Constructional apraxia
• Left-sided sensory loss
• Left-sided weakness, face
• Eye deviation to the right (RIGHT FRONTAL EYE FIELD)
• Left inferior quandrantonopia