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?