aspirin after thrombolysis?
not straight away - Following thrombolysis, aspirin should be delayed for 24 hours, and a CT should be arranged to ensure there is no haemorrhage.
The presence of Horner’s syndrome (ptosis and miosis) on the same side as trauma, plus contralateral limb weakness, strongly suggests
carotid artery dissection with cerebral ischaemia (due to thromboembolism). CT angiography allows visualisation of the arterial wall, intimal flap, and potential thrombus formation.
A 68 year old woman presents with right sided arm weakness, right sided facial droop and slurring of speech. On examination of her visual fields, she is found to have a right sided inferior homonymous quadrantanopia.
Which structure is likely to be have been damaged to produce these signs?
left parietal
Right inferior - controlled by left parietal
Right superior - controlled by left temporal
(counterintuitive to positions of lobes)
A 57-year-old man presents to the Emergency Department complaining of a clumsy right hand and difficulty speaking. His symptoms came on that morning, and were still present 8 hours later. His past medical history includes hypertension and migraines as a young man. He smokes ten cigarettes per day. On examination he was found to have some weakness of the intrinsic hand muscles on his right side only. Speech was mildly slurred. Visual fields and sensation were normal. Blood pressure was 180/110 mmHg.
Which one of the following is the most likely diagnosis?
Left hemisphere lacunar stroke
This man’s presentation with weakness of the intrinsic hand muscles and slurred speech is compatible with clumsy-hand dysarthria, one of the five classic lacunar syndromes, caused by lacunar infarcts
Mechanical Thrombectomy provides the most benefit in those with
proximal middle cerebral artery or internal carotid artery thrombus.
pt on warfarin with haemorrhagic stroke
Start labetalol, stop warfarin and give IV vitamin K and prothrombin complex concentrate
BP control is vital
hyperdense area suggests
haemorrhagic stroke
