Prevalence
Clinical
features
Investigations
Therapy
Prevention
Prognosis
|  | | | Clinical
features |
Ask about risk factors for stroke
-
hypertension (particularly a diastolic BP ≥ 100 mmHg)
a b
-
atrial fibrillation
a
-
diabetes mellitus
a
b
-
smoking
a
-
high cholesterol
a
-
history of stroke or TIA b particularly with other risk factors
b
-
ischaemic
heart disease
b
-
valvular heart disease
a
-
infection within the previous week
b
-
oral contraceptive pill use
b
The risk of stroke increases with increasing numbers of risk factors
b
Also ask about
-
a history of depression
a
A stroke is less likely with
-
hormone replacement therapy
a
-
moderate alcohol consumption
a
Listen for
-
a carotid bruit
a particularly with a history of TIA or diabetes
a
-
mitral valve prolapse
b
-
aortic stenosis
a
Assess your patient's functional status specifically looking at
-
upper limb motor function b
-
proprioception b
-
ability to stand and walk b
-
dysphagia
a
-
visual neglect
c
-
urinary incontinence
b
-
a reduced level of consciousness
a b
Classify your patient's type of stroke (based on maximal deficit).
a
The clinical features of stroke subtypes
| Stroke subtype |
features |
| lacunar infarcts (LACI) |
pure motor or sensory stroke, sensorimotor
stroke, or ataxic hemiparesis |
| total anterior circulation infarcts (TACI) |
a combination of new higher cerebral
dysfunction (e.g., dysphasia), homonymous visual field defect, and
ipsilateral motor or sensory deficit of at least 2 areas of face,
arm, and leg |
| partial anterior circulation infarcts (PACI) |
only 2 of 3 components of TACI; higher
cerebral dysfunction alone or with motor/sensory deficit more
restricted than for LACI |
| posterior circulation infarcts (POCI) |
brain stem or cerebellar dysfunction |
|
internal medicine