Ischemic stroke physical examination: Difference between revisions
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===Glassgow coma score=== | ===Glassgow coma score=== | ||
Glassgow coma score helps determine the severity of infaction | Glassgow coma score helps determine the severity of infaction, extent of damage and prognosis in unconscious or semi conscious patients. <ref name="pmid10863122">{{cite journal| author=Sternbach GL| title=The Glasgow coma scale. | journal=J Emerg Med | year= 2000 | volume= 19 | issue= 1 | pages= 67-71 | pmid=10863122 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10863122 }} </ref><ref name="pmid: 26564211">{{cite journal| author=Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI| title=The reliability of the Glasgow Coma Scale: a systematic review. | journal=Intensive Care Med | year= 2016 | volume= 42 | issue= 1 | pages= 3-15 | pmid=: 26564211 | doi=10.1007/s00134-015-4124-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26564211 }} </ref><ref name="pmid14631703">{{cite journal| author=Gabbe BJ, Cameron PA, Finch CF| title=The status of the Glasgow Coma Scale. | journal=Emerg Med (Fremantle) | year= 2003 | volume= 15 | issue= 4 | pages= 353-60 | pmid=14631703 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14631703 }} </ref><ref name="pmid16009770">{{cite journal| author=Tsao JW, Hemphill JC, Johnston SC, Smith WS, Bonovich DC| title=Initial Glasgow Coma Scale score predicts outcome following thrombolysis for posterior circulation stroke. | journal=Arch Neurol | year= 2005 | volume= 62 | issue= 7 | pages= 1126-9 | pmid=16009770 | doi=10.1001/archneur.62.7.1126 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16009770 }} </ref><ref name="pmid2509651">{{cite journal| author=Haug RH, Picard U, Matejczyk MB, Indresano AT| title=The infected prosthetic total temporomandibular joint replacement: report of two cases. | journal=J Oral Maxillofac Surg | year= 1989 | volume= 47 | issue= 11 | pages= 1210-4 | pmid=2509651 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2509651 }} </ref> | ||
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Revision as of 15:25, 14 November 2016
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Ischemic Stroke Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ischemic stroke physical examination On the Web |
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American Roentgen Ray Society Images of Ischemic stroke physical examination |
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Risk calculators and risk factors for Ischemic stroke physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
A systematic review found that acute facial paresis, arm drift, or abnormal speech are the best findings.[1]
Physical Examination
| Site of Infarction | Specific area involved | Physical exam findings | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Motor strength | Reflexes | Cranial nerves involved | Sensations | Coordination | Babinski's sign | Pupils | Pupillary reflex | ||
| Cerebral cortex | Frontal lobe
Perietal lobe temporal lobe Occipital lobe |
++ | + | ++ | + | + | ++ | + | + |
| Brain stem |
|
++ | ++ | ++ | + | + | ++ | + | + |
| Cerebellum | Community-acquired, ingestion of undercooked poultry | ++ | + | ++ | + | + | ++ | + | + |
| "Central pathway involved" |
|
± | + | ++ | ++ | + | ++ | + | + |
Glassgow coma score
Glassgow coma score helps determine the severity of infaction, extent of damage and prognosis in unconscious or semi conscious patients. [2][3][4][5][6]
| Parameter | Patient response | Glassgow coma score |
|---|---|---|
| Eye opening |
|
|
| Verbal response |
|
|
| Motor response |
|
|
Appearance
The patient may appear confused.
Eye
- Vision problems may be present.
- Drooping of eyelid (ptosis) and weakness of ocular muscles
Ear
- Altered hearing may be present.
Extremities
Neurologic
- Abnormal speech
- Acute facial paresis
- Decreased reflexes: gag, swallow, pupil reactivity to light
- Disorganized thinking, confusion, hypersexual gestures (with involvement of frontal lobe)
- Hemineglect (involvement of parietal lobe)
- Loss of co-ordination
- Memory deficits (involvement of temporal lobe)
- Numbness
- Reduction in sensory or vibratory sensation
References
- ↑ 1.0 1.1 Goldstein L, Simel D (2005). "Is this patient having a stroke?". JAMA. 293 (19): 2391–402. doi:10.1001/jama.296.16.2012 url=http://jama.ama-assn.org/cgi/content/full/296/16/2012 Check
|doi=value (help). PMID 15900010. - ↑ Sternbach GL (2000). "The Glasgow coma scale". J Emerg Med. 19 (1): 67–71. PMID 10863122.
- ↑ Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI (2016). "The reliability of the Glasgow Coma Scale: a systematic review". Intensive Care Med. 42 (1): 3–15. doi:10.1007/s00134-015-4124-3. PMID 26564211 : 26564211 Check
|pmid=value (help). - ↑ Gabbe BJ, Cameron PA, Finch CF (2003). "The status of the Glasgow Coma Scale". Emerg Med (Fremantle). 15 (4): 353–60. PMID 14631703.
- ↑ Tsao JW, Hemphill JC, Johnston SC, Smith WS, Bonovich DC (2005). "Initial Glasgow Coma Scale score predicts outcome following thrombolysis for posterior circulation stroke". Arch Neurol. 62 (7): 1126–9. doi:10.1001/archneur.62.7.1126. PMID 16009770.
- ↑ Haug RH, Picard U, Matejczyk MB, Indresano AT (1989). "The infected prosthetic total temporomandibular joint replacement: report of two cases". J Oral Maxillofac Surg. 47 (11): 1210–4. PMID 2509651.