Pathophysiology of Stroke 11_19_12

2 smith ws english jd johnston sc cerebrovascular

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2. Smith WS, English JD, Johnston SC. Cerebrovascular Diseases. In: Longo DL, Fauci AS, Kasper DL, et al., eds. H arrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012. . [Accessed 02 Nov 2012]
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Diagnosis Location of injury determined by neurologic examination and confirmed by imaging studies Further diagnostic tests are then performed to identify the cause of the patient’s stroke Patient may not be able to reliably report the history due to cognitive or language deficits 1. Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356. 2. Image: [Accessed 30 Oct 2012].
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Symptoms Weakness on one side of the body Inability to speak Loss of vision Vertigo Falling Possible headache More severe with hemorrhagic stroke 1. Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356. 2. Image: Wall HK, Beagan BM, O’Neill HJ, et al. Addressing stroke signs and symptoms through public education: the Stroke Heroes Act FAST campaign. Prev Chronic Dis 2008;5(2). . [Accessed 30 Oct 2012].
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Signs Multiple signs of neurologic dysfunction Hemi- or monoparesis Hemisensory deficit Vertigo, double vision Aphasia Expressive vs. receptive Dysphagia Dysarthria Visual field defects 1. Fagan SC, Hess DC. Stroke. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:353-356. 2. Image: [Accessed 30 Oct 2012].
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Clinical Features in Ischemic Stroke Artery Symptoms and Signs Anterior cerebral Paresis and sensory loss of contralateral leg and foot Middle cerebral Aphasia, neglect, contralateral hemisensory loss, homonymous hemianopia, hemiparesis Vertebral Ipsilateral cerebellar ataxia, Horner’s syndrome, crossed sensory loss, nystagmus, vertigo, hiccup, dysarthria, dysphagia Basilar Nystagmus, vertigo, diplopia, skew deviation, gaze palsies, hemi- or crossed sensory loss, dysarthria, hemi- or quadriparesis, ipsilateral cerebellar ataxia, Horner’s syndrome, coma Posterior cerebral Distal: contralateral homonymous hemianopia, dyslexia, visual hallucinations, memory defect, cortical blindness Proximal: Sensory loss, ataxia, third nerve palsy, contralateral hemiparesis, vertical gaze palsy, skew deviation, hemiballismus, choreoathetosis, impaired consciousness Adapted from: Lomen-Hoerth C, Messing RO. Nervous System Disorders. In: McPhee SJ, Hammer GD, editors. Pathophysiology of Disease. 6th ed. New York: McGraw-Hill; 2010. .
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