Case history
Case history
A 70-year-old right-handed man is discovered by a family member to have difficulty speaking and comprehending spoken language, and an inability to raise his right arm. He was last known to be fully functional 1 hour ago when the family member spoke to him by phone. There is a history of treated hypertension and diabetes.
Other presentations
The presenting symptoms of stroke vary by cerebral location. Most common symptoms are partial or total loss of strength in upper and/or lower extremities, expressive and/or receptive language dysfunction, sensory loss in upper and/or lower extremities, visual field loss, slurred speech, or difficulty with fine motor co-ordination and gait. In most cases the symptoms appear rapidly, over seconds or minutes, and may be preceded by one or more transient ischaemic attacks. There are no symptoms or signs that reliably distinguish between ischaemic and haemorrhagic stroke. The acute onset of neurological symptoms referable to the brain territory of a cerebral artery strongly suggests ischaemic stroke, but mimicking conditions such as intracerebral haemorrhage, focal seizure, and complicated migraine need to be considered and excluded.
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