Clinical Case Database / Category: Clinical Care
Management of acute stroke
Dr Katherine Athorn MBChB MRCP, Joanna Corrado, Dr Oliver J Corrado MBChB FRCP(Lond)
Foundation Years Journal, volume 2, issue 6, p.281 (123Doc Education, London, July 2008)
An 80-year-old woman was found lying on the floor by her daughter and when the paramedics arrived, her eyes were deviated to the left, she had a right-sided hemiparesis, with a Medical Research Council (MRC) grade 1/5 weakness of the upper and lower limb and she was aphasic. There was no evidence of head injury. She was in sinus rhythm with a rate of 80 beats per minute, blood pressure of 170/100mmHg and capillary glucose of 5.7mmol/L. There were no bruits or murmurs audible on examination and she had no abnormalities on respiratory or abdominal examination. You are called to assess the patient in the emergency department.
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Dr Katherine Athorn MBChB MRCP
SpR Geriatric Medicine
Leeds General Infirmary
Great George Street
Year 4 Medical Student
University of Manchester Medical School
Dr Oliver J Corrado MBChB FRCP(Lond)
Leeds General Infirmary and
Director of the West Yorkshire Foundation School
1. NICE. Stroke: Diagnosis and initial management of acute stroke and transient ischaemic attack 2008, Developed by the National Collaborating Centre for Chronic Conditions.
2. The Intercollegiate Working Party for Stroke. National Clinical Guidelines for Stroke. 2000 London: Royal College of Physicians.
3. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bulletin of the World Health Organization 1976 54:541-553.
4. Bath PMW, Lees KR. ABC of arterial and venous disease: acute stroke. British Medical Journal 2000 320:920-923.
5. National Audit Office. Reducing Brain Damage: faster access to better stroke care 2005 (HC 452 Session 2005-2006). London: NAO.
6. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974 2:81-84.
7. Mann G, Hankey GJ, Cameron D. Swallowing disorders following acute stroke: prevalence and diagnostic accuracy. Cerebrovascular Dis 2000 10:380-386.
8. Warlow C, Sudlow C, Dennis M, et al. Stroke. Lancet 2003 362:1211-1224.
9. North American Symptomatic Carotid Endarterectomy Trial collaborators. Beneficial effects of carotid endarterectomy in symptomatic patients with high grade stenosis. N Engl J Med 1991 325:445-453.
10. Bamford J, Sandercock P, Dennis M, et al. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991 337:1521-1526.
11. Mead G, Lewis S, W ardlaw J, et al. How well does the Oxfordshire Community Stroke P roject classification predict the site and size of the infarct on brain imaging? J Neurol Neurosurg Psychiatry 2000 68: 558â€“562.
12. Warlow C, van Gijn J, Dennis M, et al. Stroke: Practical Management. 3rd edn, 2008. Oxford: Blackwell Publishing.
13. Hankey G. Clinical Update: management of stroke. Lancet 2007 369: 1330-1332.
14. Stroke Unit Trialistsâ€™ Collaberation 1997. Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. BMJ 1997 314:1151-1159
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About the Clinical Cases Database
The 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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