Stroke Clinical Case

Question 1

A 65-year-old hypertensive man presents with sudden right-sided weakness and slurred speech. His BP is 190/110 mmHg. CT brain shows no hemorrhage. What is the most likely diagnosis, and what is the next step in management?

Answer 1

Acute ischemic stroke. Initiate thrombolysis if within 4.5 hours of symptom onset and no contraindications.

Question 2

A 70-year-old woman with atrial fibrillation develops sudden left-sided weakness. Her INR is 1.0. CT brain is normal. What is the most likely cause of her stroke?

Answer 2

Cardioembolic stroke due to atrial fibrillation. Consider anticoagulation after ruling out hemorrhage.

Question 3

A 55-year-old man with diabetes presents with right arm weakness and dysarthria. Symptoms resolve within 20 minutes. What is the most likely diagnosis?

Answer 3

Transient ischemic attack (TIA). Requires urgent stroke risk stratification using ABCD2 score and secondary prevention.

Question 4

A 45-year-old man collapses suddenly at work. He has a severe headache, vomiting, and loss of consciousness. CT shows subarachnoid hemorrhage. What is the definitive treatment?

Answer 4

Neurosurgical clipping or endovascular coiling of the aneurysm.

Question 5

A 60-year-old woman presents with acute left-sided weakness and sensory loss. She has a history of uncontrolled hypertension. CT shows a deep basal ganglia hemorrhage. What is the most likely cause?

Answer 5

Hypertensive intracerebral hemorrhage due to chronic hypertension.

Question 6

A 50-year-old man presents with sudden right-sided weakness and neglect. He has a history of hyperlipidemia and smoking. What is the most likely stroke subtype?

Answer 6

Middle cerebral artery (MCA) stroke.

Question 7

A 75-year-old woman presents with vertigo, ataxia, and right-sided facial weakness. She has a history of hypertension. What stroke syndrome is likely?

Answer 7

Brainstem stroke (likely posterior circulation stroke). Requires MRI for better evaluation.

Question 8

A 40-year-old man with sickle cell disease presents with left-sided weakness. CT shows no hemorrhage. What is the most likely mechanism of stroke?

Answer 8

Ischemic stroke due to sickle cell-related vasculopathy. Exchange transfusion may be needed.

Question 9

A 68-year-old man presents with sudden loss of vision in one eye and right-sided weakness. CT shows an infarct in the posterior cerebral artery territory. What is the classical visual deficit seen in PCA strokes?

Answer 9

Homonymous hemianopia.

Question 10

A 55-year-old diabetic man presents with pure motor hemiparesis affecting the left side. MRI shows a small infarct in the internal capsule. What type of stroke is this?

Answer 10

Lacunar stroke due to small vessel disease.

Question 11

Case 11: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 11

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 12

Case 12: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 12

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 13

Case 13: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 13

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 14

Case 14: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 14

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 15

Case 15: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 15

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 16

Case 16: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 16

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 17

Case 17: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 17

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 18

Case 18: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 18

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 19

Case 19: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 19

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 20

Case 20: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 20

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 21

Case 21: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 21

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 22

Case 22: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 22

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 23

Case 23: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 23

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 24

Case 24: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 24

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 25

Case 25: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 25

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 26

Case 26: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 26

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 27

Case 27: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 27

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 28

Case 28: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 28

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 29

Case 29: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 29

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 30

Case 30: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 30

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 31

Case 31: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 31

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 32

Case 32: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 32

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 33

Case 33: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 33

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 34

Case 34: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 34

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 35

Case 35: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 35

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 36

Case 36: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 36

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 37

Case 37: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 37

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 38

Case 38: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 38

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 39

Case 39: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 39

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 40

Case 40: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 40

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 41

Case 41: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 41

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 42

Case 42: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 42

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 43

Case 43: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 43

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 44

Case 44: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 44

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 45

Case 45: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 45

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 46

Case 46: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 46

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 47

Case 47: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 47

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 48

Case 48: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 48

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 49

Case 49: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 49

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 50

Case 50: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 50

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 51

Case 51: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 51

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 52

Case 52: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 52

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 53

Case 53: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 53

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 54

Case 54: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 54

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 55

Case 55: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 55

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 56

Case 56: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 56

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 57

Case 57: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 57

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 58

Case 58: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 58

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 59

Case 59: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 59

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.

Question 60

Case 60: A patient presents with sudden neurological symptoms suggestive of stroke. What would be the best initial imaging study?

Answer 60

Non-contrast CT brain is the first-line imaging study to differentiate ischemic from hemorrhagic stroke.