ABSTRACT
Motor-weakness, paralysis on one side of the body-face, arm, leg Aphasia-language disturbance (verbal, reading, writing)
Hemispatial neglect-right hemisphere syndrome of inattention Vision loss-hemifield or quadrantic field visual loss
l Other symptoms include the following: Sensory loss-anesthesia or paresthesia on one side of the body Ataxia of limbs, ataxia of gait Diplopia Dysphagia, dysarthria Altered level of consciousness (LOC) Apnea
l General symptoms include the following: Headache-sudden, thunderclap, “worst headache of my life” is
typically associated with SAH or venous sinus thrombosis, but is
also seen with acute ischemic stroke and ICH Vomiting Diaphoresis Tachycardia-particularly with acute onset atrial fibrillation Hypertension-very common in the acute period (first 48 hours)
DIAGNOSIS
l Diagnosis is based on clinical signs and symptoms. l Statistically, acute neurological deficits in an adult are a stroke until
proven otherwise. l Imaging (CT or MR) is required to distinguish ischemia from hemorrhage;
statistically, ischemia is a more likely cause of an acute neurological
syndrome, but reliable rules for clinical prediction to distinguish hemor-
rhage from ischemia are not available (Fig. 7.1). l Acute angiographic imaging (CTA or MRA) is critical in acute decision
making. l The majority (*70%) of ischemic stroke syndromes are minor or mild,
such patients are not eligible for thrombolysis.
