Ischemic stroke physical examination: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Aysha Aslam (talk | contribs)
nocaptcha
3,561 edits
Aysha Aslam (talk | contribs)
nocaptcha
3,561 edits
Line 7: Line 7:
A [[systematic review]] found that acute facial paresis, arm drift, or abnormal speech are the best findings.<ref name="pmid15900010">{{cite journal |author=Goldstein L, Simel D |title=Is this patient having a stroke? |journal=JAMA |volume=293 |issue=19 |pages=2391-402 |year=2005 |id=PMID 15900010 | doi=10.1001/jama.296.16.2012  url=http://jama.ama-assn.org/cgi/content/full/296/16/2012}}</ref>
A [[systematic review]] found that acute facial paresis, arm drift, or abnormal speech are the best findings.<ref name="pmid15900010">{{cite journal |author=Goldstein L, Simel D |title=Is this patient having a stroke? |journal=JAMA |volume=293 |issue=19 |pages=2391-402 |year=2005 |id=PMID 15900010 | doi=10.1001/jama.296.16.2012  url=http://jama.ama-assn.org/cgi/content/full/296/16/2012}}</ref>
==Physical Examination==
==Physical Examination==
===Glassgow coma score===
Glassgow coma score helps determine the severity of infaction and extent of damage.
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Parameter}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Patient response}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Glassgow coma score}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Eye opening'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Frontal lobe
*Temporal
*Parietal
*Occipital
| style="padding: 5px 5px; background: #F5F5F5;" |
*A
*B
*C
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Motor response'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Midbrain
*Pons
*Medulla
| style="padding: 5px 5px; background: #F5F5F5;" |
A
B
C
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Verbal response'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*A
*B
*C
*D
| style="padding: 5px 5px; background: #F5F5F5;" |
*A
*B
*C
*D
|-
|}
  {| style="border: 0px; font-size: 90%; margin: 3px;" align=center
  {| style="border: 0px; font-size: 90%; margin: 3px;" align=center
! style="background: #4479BA; padding: 5px 5px;" rowspan=2 | {{fontcolor|#FFFFFF|Site of Infarction}}
! style="background: #4479BA; padding: 5px 5px;" rowspan=2 | {{fontcolor|#FFFFFF|Site of Infarction}}
Line 118: Line 75:
! style="padding: 5px 5px; background: #F5F5F5;" | +
! style="padding: 5px 5px; background: #F5F5F5;" | +
|}
|}
===Glassgow coma score===
Glassgow coma score helps determine the severity of infaction and extent of damage.
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Parameter}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Patient response}}
! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF|Glassgow coma score}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Eye opening'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Frontal lobe
*Temporal
*Parietal
*Occipital
| style="padding: 5px 5px; background: #F5F5F5;" |
*A
*B
*C
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Motor response'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Midbrain
*Pons
*Medulla
| style="padding: 5px 5px; background: #F5F5F5;" |
A
B
C
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Verbal response'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*A
*B
*C
*D
| style="padding: 5px 5px; background: #F5F5F5;" |
*A
*B
*C
*D
|-
|}
===Appearance===
===Appearance===
The patient may appear confused.
The patient may appear confused.

Revision as of 20:20, 5 November 2016

Stroke Main page

Patient Information

Overview

Causes

Classification

Hemorrhagic stroke
Ischemic stroke

Differentiating Stroke from other Diseases

Epidemiology and Demographics

Diagnosis

NIH stroke scale
Glasgow coma scale

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ischemic stroke physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ischemic stroke physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ischemic stroke physical examination

CDC on Ischemic stroke physical examination

Ischemic stroke physical examination in the news

Blogs on Ischemic stroke physical examination

Directions to Hospitals Treating Psoriasis

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
  • Midbrain
  • Pons
  • Medulla
 ++ ++ ++ + + ++ + +
Cerebellum Community-acquired, ingestion of undercooked poultry ++ + ++ + + ++ + +
"Central pathway involved"
  • Spinothalamic tract
  • Corticospinal tract
  • Medial leminscus
 ± + ++ ++ + ++ + +

Glassgow coma score

Glassgow coma score helps determine the severity of infaction and extent of damage.

Parameter Patient response Glassgow coma score
Eye opening
  • Frontal lobe
  • Temporal
  • Parietal
  • Occipital
  • A
  • B
  • C
Motor response
  • Midbrain
  • Pons
  • Medulla

A B C

Verbal response
  • A
  • B
  • C
  • D
  • A
  • B
  • C
  • D

Appearance

The patient may appear confused.

Eye

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. ↑ 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.

Template:WS Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=Ischemic_stroke_physical_examination&oldid=1267243"