Clinical Case Database / Category: Patient Management

Management of ischaemic stroke on the acute medical unit (AMU)

Publication details

Matilda Lawrence, Sam Limaye, Tom Heaps
Foundation Years Journal, volume 4, issue 5, p.34 (123Doc Education, London, May 2010)

Abstract

Mr J, a 76-year-old male, is referred to the AMU with a 3-hour history of dense left-sided weakness, homonymous hemianopia, slurred speech and difficulty swallowing. His symptoms were present on waking earlier that morning. He has a past medical history of tablet-controlled type 2 diabetes and hypertension. He smokes 10 cigarettes per day (30 pack-year history) and drinks 40 units of alcohol per week.

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Authors

Matilda Lawrence

FY1 in Acute Medicine
Leeds General Infirmary
Great George Street, Leeds, LS1 3EX

Sam Limaye

Consultant in Stroke Medicine
York District Hospital
Wigginton Road, York, YO31 8HE

Tom Heaps (Corresponding author)

ST5 in Acute Medicine
Leeds General Infirmary
Great George Street, Leeds, LS1 3EX
tomheaps@hotmail.co.uk

References

1.  Cooper J (2009) Transient Ischaemic Attack and Stroke. In N Cooper, K Forrest, G Mulley (eds). ABC of Geriatric Medicine. Wiley-Blackwell Publishing, p. 34–38.

2.  National Collaborating Centre for Chronic Conditions (2008) Stroke: national clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). London: Royal College of Physicians.

3.  Dennis M, Sandercock PA, Reid J, et al. (2009) Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial. Lancet, 373(9679):1958–1965.

4.  Wahlgren N, Ahmed N, Davalos A, Hacke W, Millan M, Muir K, et al. (2008) Thrombolysis with alteplase 3 to 4.5 hours after acute ischaemic stroke (SITS–ISTR): an observational study. Lancet, 372(9646):1303–1309.

5.  Hacke W, Kaste M, Bluhmki E, Brozman M, Davalos A, Guidetti D, et al. (2008) Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. New England Journal of Medicine, 359(13):1317–1329.

6.  Driver and Vehicle Licensing Agency (2009) At a glance guide to the current medical standards of fitness to drive. Swansea: Drivers Medical Group. Available online at http://www.dft.gov.uk/dvla/medical/ataglance.aspx

7.  Stroke Unit Trialists’ Collaboration (2002) Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews. CD000197.

8.  Indredavik B, Bakke F, Slordahl SA, Rokseth R and Haheim LL (1999) Stroke unit treatment: 10-year follow-up. Stroke, 30:1524–1527.

9.  Jorgensen HS, Kammersgaard LP, Nakayama H, et al. (1999) Treatment and rehabilitation on a stroke unit improves 5-year survival. A community-based study. Stroke, 30:930–933.

10.  Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ (2001) Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA, 285(22):2864–2870.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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