ER - stroke

Question 1

neurologic presenting symptoms of stroke

Answer 1

vision, 
changes in speech, 
focal numbness or weakness, 
disequilibrium
alteration in level of consciousness

Question 2

ddx for stroke

Answer 2

Peripheral Neuropathy (Bell’s palsy)
Complicated Migraine

Structural brain lesion (tumor, AVM, aneurysm, hemorrhage)
Infection (cerebral abscess, septic emboli)
Seizure Disorder and post-seizure neurologic deficit (Todd’s paralysis)
Toxic-metabolic disorders (Hypoglycemia and Hyponatremia)

Question 3

What is the single most important part of the stroke history?

Answer 3

exact time of onset of symptoms

Question 4

Why is it important to determine the time course and pattern of symptoms in suspected stroke?

What pattern makes you suspect true stroke?

Answer 4

Symptoms which achieve maximal intensity within seconds to minutes of onset and simultaneously affect multiple different systems at once are typical of stroke.

In contrast, symptoms which progress slowly over time or progress from one area of the body to another are more suggestive of stroke mimic.

Question 5

Stroke risk factors?

Answer 5

HTN, DM, DLD, smoking, ASCVD
afib
prosthetic heart valves
prior stroke
age