STROKE-DIAGNOSIS

SUMMARY

1. History: sudden onset of focal deficit, referable to a single site in the central nervous system e.g. hemiparesis, aphasia, hemianopia, amaurosis fugax, diplopia.

2. Delirium: confusion, disorientation and altered conscious state are more often metabolic/delirium but beware the uncooperative aphasic patient.

3. Examination: localise deficit: ?cortical signs – aphasia, inattention, hemianopia.

4. Imaging: CT brain, CT perfusion, CT angiography +/- follow-up MRI for diagnostic confirmation.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].