Hemorrhagic stroke physical examination: Difference between revisions
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==Physical examination== | ==Physical examination== | ||
Physical examination of patients with Intracerebral hemorrhage is usually varies based on the location of the bleeding. | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Putamenal hemorrhage''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Putamenal hemorrhage''' | ||
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*[[Hemiplegia]] | *[[Hemiplegia]] | ||
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*[[Coma]] | *[[Coma]] | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Thalamic hemorrhage''' | | rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" | '''Thalamic hemorrhage''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |General signs: | ||
* | *Downward gaze (paralysis of upward gaze) | ||
*Small pupils (lack of light pupillary response) | *Small pupils (lack of light pupillary response) | ||
*Depressed consciousness | *Depressed consciousness | ||
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*Impairment of verbal memory | *Impairment of verbal memory | ||
*Visuospatial dysfunction | *Visuospatial dysfunction | ||
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|Behavioural patterns based on the four main arterial thalamic territories: | |||
*Anterior: perservations, [[apathy]], and [[amnesia]] | |||
**Paramedian infarction: [[disinhibition]], personality change and [[amnesia]] (severe retrograde and [[anterograde amnesia]]) | |||
**Extensive lesions: "thalamic dementia" | |||
*Inferolateral: Executive dysfunction and occasionally severe long term disability | |||
*Posterior: No specific behavioural pattern however can include [[cognitive dysfunction]], [[neglect]], [[aphasia]] | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Pontine hemorrhage''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Pontine hemorrhage''' | ||
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*Decreased level of consciousness (most common) | *Decreased level of consciousness (most common) | ||
*Long tract signs including | *Long tract signs including [[tetraparesis]] | ||
*Cranial nerve palsies | *[[Cranial nerve palsies]] | ||
*[[Seizures]] | *[[Seizures]] | ||
*Cheyne-Stokes respiration | *[[Cheyne-Stokes respiration]] | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Cerebellar hemorrhage''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Cerebellar hemorrhage''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Small bleeds | *Small bleeds | ||
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| style="padding: 5px 5px; background: #DCDCDC;" |''' Lobar hemorrhage | | style="padding: 5px 5px; background: #DCDCDC;" |''' Lobar hemorrhage | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |The signs vary depending on the location of the hemorrhage: | ||
*Acute neurological deterioration | *Acute neurological deterioration | ||
*Decreased GCS | *Decreased GCS | ||
*[[Seizure]] | |||
*Contralateral [[homonymous hemianopsia]] (occipital hemorrhage) | |||
*Contralateral plegia/[[paresis]] of the leg with relative sparing of the arm (frontal hemorrhage) | |||
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Revision as of 03:25, 30 November 2016
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Hemorrhagic stroke Microchapters |
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Diagnosis |
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Treatment |
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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012) |
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AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
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AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (2014) Sex-Specific Risk Factors
Risk Factors Commoner in Women |
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Case Studies |
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Hemorrhagic stroke physical examination On the Web |
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American Roentgen Ray Society Images of Hemorrhagic stroke physical examination |
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Risk calculators and risk factors for Hemorrhagic stroke physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examination
Physical examination of patients with Intracerebral hemorrhage is usually varies based on the location of the bleeding.
| Locations | Physical examination |
|---|---|
| Putamenal hemorrhage | |
| Thalamic hemorrhage | General signs:
|
Behavioural patterns based on the four main arterial thalamic territories:
| |
| Pontine hemorrhage |
|
| Cerebellar hemorrhage |
|
| Lobar hemorrhage | The signs vary depending on the location of the hemorrhage:
|