Some Cases Flashcards
1
Q
- Woman on warfarin due to previous DVT
- Sudden acute headache
- Dysphasia
- Drowsiness and vomiting
- Right sided hemiparesis
- Right sided facial weakness
- Cushings Response
A
Intercerebral haemorrhage, like to be the L MCA
2
Q
- Sudden left sided hemiparesis
- Painless
- Only hemiparesis
- She has hypertension controlled with three types of medication
- The arm leg and face are all affected equally
- The area around the eye is spared
A
- Lacunar infarct on R side internal capsule
This is an UMN disease of all the motor pathways but as CNVII has UMN input from both sides the foreheard is spared
3
Q
- 58 year old with DMI
- Sudden L Hemiparesis affecting face and arm more than legs
- No evidence of haemorrhage on CT
- BP is normal
- 40 minutes since symptoms came on
A
- TIA
- ? RMCA evolving stroke
- Treat with antithrombolytics
4
Q
- 22 with previous DVT
- Ulcerative Colitis
- Slowly evolving headache over 24 hours
- Papilloedema
- CT scan shows a bleed that doesnt respect any arterial territories
A
- CVST
- Treat with anticoagulants despite bleed
- UC relevant as inflammatory disorder (risk factor) and DVT as previous clots
5
Q
78 year old with PMH MI, hypertension, DMI, hypercholesteraemia, smoker
Acute L sided facial weakness and R hemiparesis
A
Brain stem ischaemic stroke (Pons)
Because the face and body are effected on opposite sides
6
Q
When would the opposite sides of face and body be affected?
A
Brain stem stroke due to CN not decussating and motor neurons decussating in the medulla
LMN CN and UMN body
