Case history
Case history
A 70-year-old right-handed man is found by a family member to have difficulty speaking and comprehending spoken language, and an inability to raise his right arm. He was known to be well 1 hour ago when the family member spoke to him by phone. He has a history of treated hypertension and diabetes.
Other presentations
The presenting symptoms of stroke vary by cerebral location. The 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; difficulty with fine motor coordination and gait; loss of balance; vertigo with or without additional neurologic symptoms; and binocular diplopia.
In most cases the symptoms appear rapidly, over seconds or minutes, are one-sided, and may be preceded by one or more transient ischemic attacks. There are no symptoms or signs that reliably distinguish between ischemic stroke and hemorrhagic stroke. The acute onset of neurologic symptoms referable to the brain territory of a cerebral artery strongly suggests ischemic stroke, but mimicking conditions such as intracerebral hemorrhage, focal seizure, and complicated migraine need to be considered and excluded. The sudden onset of "the worst headache in one's life" can be related to intracerebral or subarachnoid hemorrhage. Headache is the most common symptom of cerebral venous thrombosis, occurring in nearly 90% of cases.[7][8]
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