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Stroke
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
This man’s old age, diabetic medical history and focal neurological signs favour the diagnosis of acute stroke in this case, as opposed to severe migraine. The fact that the man was thrombolysed following a plain CT brain scan means that the stroke was ischaemic rather than haemorrhagic.1 In this case, it is a partial anterior circulation infarct since he has dysphasia (higher dysfunction) as well as arm and leg weakness. If he had a homonymous hemianopia also, the diagnosis would favour a total anterior circulation infarct. It is important to keep in mind that hemiplegic migraine can present like a stroke and must also not be confused with a transient ischaemic attack (TIA).
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.
Mainstream technology to support basic communication and leisure in people with neurological disorders, motor impairment and lack of speech
Published in Brain Injury, 2020
Giulio E. Lancioni, Nirbhay N. Singh, Mark F. O’Reilly, Jeff Sigafoos, Fiora D’Amico, Francesca Buonocunto, Crocefissa Lanzilotti, Gloria Alberti, Jorge Navarro
Table 1 lists the participants by their pseudonyms, and reports their ages, neurological disorders and level of functioning, as well as the time gap between the diagnosis of their neurological disorders and the start of this study. Their ages varied between 28 and 76 years. Their neurological disorders were linked to intraparenchimal hemorrhage, total anterior circulation infarct, perinatal brain injury, muscular dystrophy, Parkinson’s disease, and cervical spinal cord injury. The time interval between the diagnosis of the disorders and the start of the study varied from about 5 months to 40 years. The rehabilitation and care centers in charge of their treatment had classified their general functioning as compatible with mild/moderate intellectual disability, mild cognitive impairment (20) or the VI and VII levels of the Levels of Cognitive Functioning Scale-Revised (21).