Ischemic stroke physical examination: Difference between revisions
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Eye opening''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Eye opening''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | *Spontaneous | ||
* | *To speech | ||
* | *To pain | ||
* | *No response | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | *4 | ||
* | *3 | ||
* | *2 | ||
*1 | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |''' | | style="padding: 5px 5px; background: #DCDCDC;" |'''Verbal response''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | *Oriented to time, place and person | ||
* | *Confused | ||
* | *Inappropriate words | ||
*Incomprehensible words | |||
*No response | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* 5 | |||
* 4 | |||
* 3 | |||
* 2 | |||
* 1 | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | ''' | | style="padding: 5px 5px; background: #DCDCDC;" |''''''Motor response'''''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | *Obeys commands | ||
* | *Moves to localized pain | ||
* | *[[Flexion]] withdrawl from pain | ||
* | *Abnormal flexion to pain ([[decorticate posture]]) | ||
*Abnormal extension to pain (decerebrate posture) | |||
*No response | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | * 6 | ||
* | * 5 | ||
* | * 4 | ||
* | * 3 | ||
* 2 | |||
* 1 | |||
|- | |- | ||
|} | |} |
Revision as of 15:18, 14 November 2016
Ischemic Stroke Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Ischemic stroke physical examination On the Web |
American Roentgen Ray Society Images of Ischemic stroke physical examination |
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 and extent of damage.
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.