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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A day 2 postpartum woman in Intensive Care has a CT brain followed by an MRI brain after she was neurologically inappropriate during a sedation hold. The patient experienced a period of hypertension secondary to pre-eclampsia which has now resolved. Clinically the differential lies between posterior reversible encephalopathy syndrome (PRES) and a posterior circulation infarct.
Head and Neck
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
Depending on how many of these features are present, four possible syndromes are possible. Total anterior circulation infarct (TACI): 10–20% strokes – worst prognosisPartial anterior circulation infarct (PACI): 30–40% strokesPosterior circulation infarct (POCI): 20–30% strokesLacunar infarct: 20–30% pure motor, pure sensory, ataxic hemiparesis
Ethical issues in stroke management
Published in Gurcharan S Rai, Jeremy Playfer, Marshall B Kapp, Gurdeep S Rai, Iva Blackman, Medical Ethics and the Elderly, 2018
Jonathan Birns, Gurcharan S Rai
The OCSP classification uses clinical localisation of the infarct topography and subdivides strokes into four groups as follows: lacunar infarct – pure motor, pure sensory, sensorimotor or ataxic hemiparesistotal anterior circulation infarct (TACI) – higher cortical dysfunction (dysphasia or visuospatial neglect), homonymous visual field defect and hemiplegia and/or sensory deficit involving at least two areas of face, arm and legpartial anterior circulation infarct (PACI) – two of the three components of TACI with higher dysfunction alone or motor/sensory deficit more restricted than those classified as lacunar eventsposterior circulation infarct (POCI) – ipsilateral cranial nerve palsy with contralateral motor and/or sensory deficit, bilateral motor and/or sensory deficit, disorder of conjugate eye movement, cerebellar dysfunction or isolated homonymous visual field defect.
Sex- related differences in the factors associated with outcomes among patients with strokes of undetermined source: a hospital-based follow-up study
Published in Postgraduate Medicine, 2021
Lili Yan, Chunmei Huangfu, Na Yang, Renzi Li, Xiuping Yang, Yujing Feng, Lihui Xuan, Qian Wang, Yanhong Meng, Xiaoqiang Hou, Xuemei Li
Patients were categorized into five age groups: <45 years, 45–54 years, 55–64 years, 65–74 years, and ≥75 years. The OCSP classification criteria divided the strokes into four subtypes: total anterior circulation infarct, partial anterior circulation infarct, posterior circulation infarct, and lacunar infarct. Stroke severity was also categorized according to the NIHSS scores as: mild (NIHSS score, ≤7), moderate (8–16), or severe (≥17). Hypertension was defined as patient-reported history of hypertension, systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, or receiving hypertension drugs; diabetes mellitus was defined as patient-reported history of diabetes, FPG levels ≥7 mmol/L, or use of antidiabetic medication; hyperlipidemia was defined as patient-reported history of hyperlipidemia, TC > 6.22 mmol/L, LDL-C level > 4.14 mmol/L, TG level > 2.26 mmol/L, or use of oral lipid-lowering medicine [24]; atrial fibrillation was defined as patient-reported history of atrial fibrillation or the presence of arrhythmia detected using 12-lead electrocardiography or 24-hour Holter rhythm monitoring during hospitalization; obesity was defined as a BMI ≥28 kg/m2 [25]; smoking was defined as smoking at least one cigarette/day for >1 year; and alcohol consumption was defined as drinking alcohol at least once/week for >1 year.