Ischemic%20stroke Signs and Symptoms

• 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
  • Brain involvement is evident clinically or as documented in imaging studies based on the onset of symptoms
• 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, emboli, or intracranial small vessel disease
• Most common risk factors include hypertension and diabetes mellitus 
• Rapid evaluation is essential for use of time-sensitive treatments and to prevent further brain damage

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)
• Apraxia 
• Visual agnosia

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, nystagmus
• Dysarthria, dysphagia
• Vertigo, syncope
• Hemiparesis or quadriplegia
• Sensory loss in hemibody or all 4 limbs
• Decreased consciousness
• Hiccups, abnormal respirations
• Alexia or inability to understand words written

Cerebellum

• Truncal/gait ataxia, limb ataxia
• Dysarthria
• Vertigo, nystagmus