ischemic%20stroke
ISCHEMIC STROKE
Ischemic stroke occurs when a blood vessel supplying the brain is obstructed.
Consider stroke in any patient presenting with sudden focal neurological deficit or any alteration in level of consciousness.
Rapid evaluation is essential for sure of time-sensitive treatments.
Determine if patient's symptoms are due to stroke and exclude stroke mimics (eg migraine, hypertensive encephalopathy, hypoglycemia, seizures or post-ictal paresis); identify other conditions requiring immediate intervention and determine the potential causes of stroke.

Introduction

  • Stroke or cerebrovascular disease is defined as a sudden onset of focal neurological deficit or any alteration in level of consciousness due to an underlying vascular pathology
  • Ischemic stroke is a type of stroke characterized by the sudden absence of blood supply to an area of the brain, spinal cord or retina secondary to a thrombus or emboli
  • Rapid evaluation is essential for use of time-sensitive treatments

Signs and Symptoms

Common Presentation of Patients with Acute Ischemic Stroke

  • Left (dominant) hemisphere
    • Left gaze preference
    • Right visual field deficit
    • Right hemiparesis
    • Right hemisensory loss
    • Dysarthria
    • Aphasia (Broca’s, Wernicke’s, Global)
  • Right (non-dominant) hemisphere
    • Right gaze preference
    • Left visual field deficit
    • Left hemiparesis
    • Left hemisensory loss (hemi-inattention)
    • Neglect of left side
    • Dysarthria
  • Brainstem
    • Nausea/vomiting
    • Diplopia, dysconjugate gaze, gaze palsy
    • Dysarthria, dysphagia
    • Vertigo
    • Hemiparesis or quadriplegia
    • Sensory loss in hemibody or all 4 limbs
    • Decreased consciousness
    • Hiccups, abnormal respirations
  • Cerebellum
    • Truncal/gait ataxia, limb ataxia
    • Dysarthria
    • Vertigo, nystagmus
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
11 Aug 2017
Eating red meat may lead to cardiovascular (CV) target organ damage over a 4-year period, according to a recent study involving hypertensive American Indians.
Pearl Toh, 08 Jun 2016
Middle East Respiratory Syndrome (MERS) patients have more severe illness and a higher mortality rate than non-MERS severe acute respiratory infection (SARI) patients, according to a study presented at the recent American Thoracic Society (ATS) International Conference 2016 held in San Francisco, California, US.
Radha Chitale, 19 May 2016
Women with atrial fibrillation (AF) are more symptomatic, more functionally impaired, and have worse quality of life compared with men with AF, although women are less likely to die, according to an observational cohort study comparing sex differences in AF.
01 Jun 2016
Valsartan plus amlodipine reduces albuminuria in chronic kidney disease (CKD) patients with hypertension, a randomised clinical trial showed.