3 Questions for Stroke Case study

Case
Study: Stroke

INITIAL HISTORY:

Ø
76
year old man, slightly confused

Ø
Wife
describes symptoms starting 30 minutes ago

Ø
Sudden
onset of difficulty getting his mouth to form words; speech is slurred

Ø
Face
and mouth numb; tongue feels thick

Ø
Unable
to hold his coffee cup in his right hand

Ø
Right
leg weak; needs to hold on to the table to stand

Question 1: What is your differential diagnosis based
on the information you have now?

Question 2:
What other
questions would you like to ask?

ADDITIONAL HISTORY:

Ø
History
of essential hypertension

Ø
Has
not been taking his thiazide diuretic because it makes him feel bad

Ø
Was
told he has high cholesterol but has not returned to see his primary care
provider

Ø
Has
experienced several brief spells of right-sided weakness which resolved in a
few minutes; thought this was his arm falling asleep

Ø
No
head trauma or recent infections

Ø
Family
history; mother died of stroke, father died of acute myocardial infarction
(AMI)

Ø
Smokes
1 pack/day of cigarettes for the past 30 years

Ø
Sedentary
lifestyle

Question 3:
Now what do you
think?

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