Presentation
CLINICAL PRESENTATION Although stroke in childhood is relatively rare, its clinical presentation is usually obvious to the paediatrician, who can investigate both obvious and subtle presentations and initiate emergency medical management. [adc.bmj.com]
Thrombotic Infarctions 1. class 2. disease causing this 3. associated diseases 4. clinical presentation 1. [quizlet.com]
Presented by the National Institute of Neurological Disorders and Stroke, a division of the National Institutes of Health. Project Stroke Hope Presentation by a family hoping to help others who are affected by stroke. [curlie.org]
The order of presentation of the films was randomized and differed for each modality. [doi.org]
Entire Body System
- Disability
Patients with severe disability had a history of many years, whereas two patients with little or moderate residual disability had a follow-up of 3 years each. CT scan revealed multifocal cerebral infarctions and cortical atrophy in all cases. [ncbi.nlm.nih.gov]
A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. [ninds.nih.gov]
Outcomes: A composite outcome of death or disability at 3 months, all strokes or early recurrent stroke within 14 d, and symptomatic intracranial bleeding. [web.archive.org]
Outcomes: A composite outcome of death or disability at ≥ 3 months, all strokes or early recurrent stroke within 14 d, and symptomatic intracranial bleeding. [acpjc.org]
- Asymptomatic
Estimated prevalence of asymptomatic CAS is 1%. Purpose: To evaluate evidence on screening and treating asymptomatic adults for CAS. [doi.org]
Structured Abstract Purpose: To evaluate the evidence on screening and treating asymptomatic adults for carotid artery stenosis (CAS) for the U.S. Preventive Services Task Force (USPSTF). [ncbi.nlm.nih.gov]
- Swelling
In both types of hemorrhagic stroke, the leaked blood causes swelling of the brain and increased pressure in the skull. The swelling and pressure damage cells and tissues in the brain. [web.archive.org]
Neurosurgical intervention can also allow patients to survive the period of maximal swelling by performing decompressive craniectomies (with or without duroplasty). [radiopaedia.org]
Researchers discovered the mechanism that, on the molecular level, fuels swelling after a stroke, traumatic brain injury and spinal cord injury, leading to a clinical trial of a medicine to reduce swelling. [umms.org]
[…] is a sudden swelling of the upper lip. 25. • Swelling of the lower lip and one or both cheeks may follow in Melkersson-Rosenthal syndrome. • Less commonly, the forehead, eyelids, or one side of the scalp may be involved. • Swelling may feel soft, firm [slideshare.net]
After a few to several hours, there may be slight swelling and softening of the tissue and slight changes in the color of the affected tissue. The swelling and softening increase over the next several days. [renaissance.stonybrookmedicine.edu]
- Congestive Heart Failure
For all outcomes, low-dose diuretics were superior to placebo: coronary heart disease (CHD; RR, 0.79; 95% confidence interval [CI], 0.69-0.92); congestive heart failure (CHF; RR, 0.51; 95% CI, 0.42-0.62); stroke (RR, 0.71; 0.63-0.81); cardiovascular disease [doi.org]
failure (an inability of the heart to pump enough blood around the body), heart disease, peripheral artery disease (obstruction of the arteries in the arms or legs), or cerebrovascular disease (problems affecting the blood vessels in the brain en The [sl.glosbe.com]
heart failure (CHF), cerebrovascular accident or transient ischemic attack, or pulmonary embolism were excluded from SUTENT clinical studies en whereas equidae are social animals with cognitive abilities and strong affiliative ties, and whereas they [glosbe.com]
heart failure (CHF), cerebrovascular accident or transient ischemic attack, or pulmonary embolism were excluded from SUTENT clinical studies et Me võime neile saba järele panna en Nervous system disorders Common: hypoaesthesia Uncommon: cerebrovascular [et.glosbe.com]
- Fatigue
[…] mots clés Post-stroke fatigue (PSF) Drugs Cognition Functional magnetic resonance imaging (fMRI) Titre traduit Post-stroke fatigue : associated factors and impact of cognitive and emotional disturbances Résumé Post-stroke fatigue (PSF) is frequent and [theses.fr]
Muscle spasm, fatigue, and weakness are symptoms. MS may occur in periodic attacks or be steadily progressive. [webmd.com]
Get regular check-ups: if you are experiencing chest pain, fatigue, shortness of breath or other symptoms, get checked out right away. The earlier you’re diagnosed and treated, the better the outcome. [baptisthealth.com]
After onset of the GFD and with iron supplement, pericardial effusion, along with peripheral edema and fatigue, decreases[ 94, 96 ]. Presence of left ventricle dilation, suggesting an initial phase of heart damage, is reversible on the GFD[ 96 ]. [doi.org]
Respiratoric
Gastrointestinal
- Vomiting
In the early stages, patients can experience these symptoms: Limp, unresponsive muscles Increased blood pressure Inability to cough Difficulty communicating Reduced field of vision Inability to recognize familiar people or objects Vomiting Seizures Irregular [eliteneurosciencecenter.com]
Ischemic stroke and intracerebral hemorrhage both present with sudden-onset focal neurologic deficits, but intracerebral hemorrhage is more commonly accompanied by headache, nausea/vomiting, and depressed level of consciousness at onset due to increased [neurology.mhmedical.com]
Nausea and vomiting Headache – Headache is worse in patients with subarachnoid hemorrhage or bleeding within the brain due to a ruptured artery or arterial aneurysm. [news-medical.net]
Symptoms of cerebrovascular disorders include: Abnormal or slurred speech Confusion, disorientation, or memory loss Difficulty with comprehension Dizziness, nausea, or vomiting Loss of balance, coordination, or the ability to walk Loss of vision or difficulty [umiamihealth.org]
- Nausea
Ischemic stroke and intracerebral hemorrhage both present with sudden-onset focal neurologic deficits, but intracerebral hemorrhage is more commonly accompanied by headache, nausea/vomiting, and depressed level of consciousness at onset due to increased [neurology.mhmedical.com]
Nausea and vomiting Headache – Headache is worse in patients with subarachnoid hemorrhage or bleeding within the brain due to a ruptured artery or arterial aneurysm. [news-medical.net]
History and Symptoms: Symptoms of a stroke include abnormal or slurred speech; dizziness and nausea; severe headache; confusion; numbness, weakness on one side—in the face, an arm or leg Physical Exam: The physician will look for the symptoms described [aapmr.org]
Symptoms of cerebrovascular disorders include: Abnormal or slurred speech Confusion, disorientation, or memory loss Difficulty with comprehension Dizziness, nausea, or vomiting Loss of balance, coordination, or the ability to walk Loss of vision or difficulty [umiamihealth.org]
Warning signs of a trans ischemic attack or stroke may include the sudden onset of some or all the following symptoms: Dizziness, nausea, or vomiting Unusually severe headache Confusion, disorientation, difficulty with comprehension, memory loss Numbness [baptisthealth.com]
Cardiovascular
- Heart Failure
The malformation is a congenital defect which can manifest as heart failure along with hydrocephalus. [childrensnational.org]
This type is often accompanied by hydrocephalus, a buildup of fluid in the brain, and signs of heart failure. [ohsu.edu]
The large reduction in the risk of heart failure in HYVET appears to be important. [doi.org]
failure (an inability of the heart to pump enough blood around the body), heart disease, peripheral artery disease (obstruction of the arteries in the arms or legs), or cerebrovascular disease (problems affecting the blood vessels in the brain en The [sl.glosbe.com]
- Tachycardia
I45 Other conduction disorders I46 Cardiac arrest I47 Paroxysmal tachycardia I48 Atrial fibrillation and flutter I49 Other cardiac arrhythmias I50 Heart failure I51 Complications and ill-defined descriptio... [icd10data.com]
There is a higher prevalence of CD in patients with Postural Orthostatic Tachycardia Syndrome (POTS)[ 163 ]; thus these patients should also be screened for CD[ 164 ]. [doi.org]
Skin
- Urticaria
Rarely contact urticaria may present as a cheilitis when the allergen is used in small amount frequently, such as the flavouring in a toothpaste. Sometimes no cause can be identified. [dermnetnz.org]
Anamnestically, there was no evidence for angioedema or urticaria. Dermatological investigation revealed swollen, erythematous to purpuric lips with small firm indurated papules at the margin of the lips and mucosa. [medicaljournals.se]
[…] ischaemic stroke, myocardial infarction or peripheral arterial disease was slightly lower with clopidogrel than aspirin (5.3% vs 5.8%), but the overall risk of bleeding was similar (9.3% each).[ 13 ] [ B ] Hypersensitivity to aspirin or NSAIDS (anaphylaxis, urticaria [web.archive.org]
[…] to −2·6) * –1·3 (−2·2 to −0·5) * Pruritus 452·1 (211·1 to 825·5) 599·8 (278·6 to 1087·3) 709·1 (329·7 to 1298·7) 56·8 (52·5 to 61·0) * 18·2 (16·7 to 19·8) * 9·4 (4·4 to 17·2) 9·6 (4·5 to 17·5) 9·7 (4·5 to 17·8) 2·9 (2·4 to 3·5) * 1·3 (0·8 to 1·8) * Urticaria [ncbi.nlm.nih.gov]
Neurologic
- Stroke
Blood transfusion is a mainstay of stroke prevention 42 as well as acute stroke management. [adc.bmj.com]
[…] of involvement of the stroke. [en.wikipedia.org]
Ischaemic Stroke A stroke is a serious medical condition that occurs when the blood supply to the brain is disturbed or interrupted. [hse.ie]
NINDS Stroke Information Page [catalog.coriell.org]
- Headache
This is also true if the headache has the characteristics of migraine, tension-type, or cluster headache. [medlink.com]
Epidemiology of headache in a general population: a prevalence study. J Clin Epidemiol. 1991. 44:1147-57. Kaniecki R. Headache assessment and management. JAMA. 2003 Mar 19. 289(11):1430-3. [Medline]. Rizzoli P, Mullally WJ. Headache. [medscape.com]
Nausea and vomiting Headache – Headache is worse in patients with subarachnoid hemorrhage or bleeding within the brain due to a ruptured artery or arterial aneurysm. [news-medical.net]
If the patient can provide a history, he often dramatically describes the pain as "the worst headache of my life." Headache may spread to the neck, intrascapular area, or even the low back. [ncbi.nlm.nih.gov]
- Intracranial Hemorrhage
Regular alcohol ingestion is associated with hypertension, fatal and nonfatal intracranial hemorrhage, cerebral infarction, and increased risk of death from stroke. [doi.org]
Interim analyses were required after every 3 symptomatic intracranial hemorrhages and after every 10 deaths. [content.nejm.org]
There are four major causes of intracranial hemorrhage: Spontaneous intracerebral hemorrhage without vascular abnormalities Cerebral aneurysms Cerebral artery and vein malformations Cavernomas. [hus.fi]
- Paresis
Focusing on 3 findings (acute facial paresis, arm drift, or abnormal speech) might improve diagnostic accuracy and reliability. Full Text [dx.doi.org]
Unilateral hemispheric cerebral oedema, for example secondary to diabetes, hyperammonaemia (ornithine carbamoyl transferase deficiency) Hemiplegic migraine (but diagnosis of exclusion – migrainous symptoms seen in cerebrovascular disease) Post-ictal (Todd’s paresis [adc.bmj.com]
- Clumsiness
[…] due to right middle cerebral artery occlusion Cerebrovascular accident due to right posterior cerebral artery occlusion Cerebrovascular accident, less than 8 weeks (disorder) CVA - cerebrovascular accident due to cerebral artery occlusion Dysarthria-clumsy [icd9data.com]
Posterior circulation ischaemia [ 1 ] : Motor deficits (weakness, clumsiness, or paralysis of any combination of arms and legs, up to quadriplegia, sometimes changing from one side to another in different attacks). [patient.info]
[…] usually less than 200 µm) due to lipohyalinosis or microatheromatosis of said vessels The clinical course is that of one of the classic lacunar syndromes (pure hemiparesis, pure sensory syndrome, sensorimotor syndrome, ataxic hemiparesis, or dysarthria-clumsy [revespcardiol.org]
Workup
"Extensive workup, including fasting lipid panel and transesophageal echocardiogram, was only significant for methamphetamine in the urine," they wrote. "No cocaine or other illicit drugs were detected." [web.archive.org]
After the history and physical exam, clinicians may move on to laboratory workup and imaging. [en.wikipedia.org]
Both the pemphigus and pemphigoid workups are complex and include histopathologic and immunofluorescent diagnostics. Lip lesions/cheilitis in association with pemphigus vulgaris. [ncbi.nlm.nih.gov]
(See Workup.) Axial noncontrast computed tomography scan of the brain of a 60-year-old man with a history of acute onset of left-sided weakness. [emedicine.com]
Treatment
Treatment is personalized for each patient by choosing from the most advanced medical, endovascular and surgical treatments, as well as ongoing clinical trials. [neurosurgery.ucsf.edu]
Common Surgical and Endovascular Procedures for Cerebrovascular Disease at Michigan Medicine Endovascular treatment of intracranial aneurysms Microsurgical treatment of intracranial aneurysms Endovascular treatment of Arteriovenous Malformations (AVMs [uofmhealth.org]
Your Loyola doctor has the latest treatments and technology to improve your condition. [loyolamedicine.org]
Neurologists work with doctors trained in brain and nervous system surgery ( neurosurgeons ) and others to provide inpatient and outpatient treatment for people who have strokes and other cerebrovascular diseases. [mayoclinic.org]
Prognosis
Prognosis Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. [ninds.nih.gov]
[…] is a comprehensive resource on clinical stroke, covering all major aspects of cerebrovascular disease, including epidemiology, risk factors, primary prevention, pathophysiology, diagnostics, clinical features, acute therapies, secondary prevention, prognosis [oxfordmedicine.com]
Each of these TIA has its own pathophysiology, clinical features, and prognosis and, thus, the treatments differ. [revespcardiol.org]
If ES worsens prognosis, the prophylactic use of anticonvulsants in patients at risk is warranted. [doi.org]
Etiology
The TOAST classification denotes five subtypes of ischemic stroke: 1) large-artery atherosclerosis, 2) cardioembolism, 3) small-vessel occlusion, 4) stroke of other determined etiology, and 5) stroke of undetermined etiology. [dx.doi.org]
Etiological and Pathogenic Classification of Stroke The etiological and pathogenic categorization of stroke is essential for its proper treatment. [revespcardiol.org]
Risk factor and etiology analysis of ischemic stroke in young adult patients. J Stroke Cerebrovasc Dis. 2014; 23:e221-7. Griffiths D, Sturm J. Epidemiology and etiology of young stroke. Stroke Res Treat. 2011:209370 Ellis C. Stroke in young adults. [spmfrjournal.org]
Epidemiology
Vascular malformation epidemiologic research Mayo's goal for epidemiologic research in vascular malformation is to define the natural course and management outcome of intracranial vascular malformation. [mayo.edu]
While the experimental evidence is exciting and provocative, epidemiological evidence also suggests a link between alcohol consumption and stroke. [doi.org]
Edited by Bo Norrving Abstract The Oxford Textbook of Stroke and Cerebrovascular Disease is a comprehensive resource on clinical stroke, covering all major aspects of cerebrovascular disease, including epidemiology, risk factors, primary prevention, pathophysiology [oxfordmedicine.com]
Epidemiology of Stroke in Innherred, Norway, 1994 to 1996 Incidence and 30-Day Case-Fatality Rate Hanne Ellekjær, MD ; Jostein Holmen, MD, PhD ; Bent Indredavik, MD ; Andreas Terent, MD, PhD From Innherred Hospital, Levanger, and National Institute of [web.archive.org]
February 2014, Vol.20, No.1 doi: 10.1212/01.CON.0000443838.95260.4b REVIEW ARTICLES Article Related Links Abstract This article discusses the physiologic changes of pregnancy and how they affect risk of ischemic and hemorrhagic stroke and then reviews epidemiology [journals.lww.com]
Pathophysiology
Edited by Bo Norrving Abstract The Oxford Textbook of Stroke and Cerebrovascular Disease is a comprehensive resource on clinical stroke, covering all major aspects of cerebrovascular disease, including epidemiology, risk factors, primary prevention, pathophysiology [oxfordmedicine.com]
The term acute ischemic cerebrovascular syndrome describes a spectrum of clinical presentations that share a similar underlying pathophysiology: cerebral ischemia. [dx.doi.org]
Acute ischemic cerebrovascular syndrome (AICS) describes a spectrum of clinical presentations that share a similar underlying pathophysiology: cerebral ischemia. [ncbi.nlm.nih.gov]
Prevention
What is primary prevention for heart attack or stroke? Primary prevention refers to prevention of heart attacks in patients with no prior history of coronary artery disease or stroke. [ Back to top ] Q2. [fda.gov]
Mayo Clinic believes that the best cure for cerebrovascular disease is prevention--preventing the degree of impairment following stroke and preventing cerebrovascular disorders themselves. [mayo.edu]
Effectiveness of Stroke Prevention Strategies Table 6. [doi.org]