Stroke in the ED Case 3
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Question 1 of 2
1. Question
A 39-year-old man, previously fit and well, had been painting the ceilings at home that morning. He was found collapsed at home by his wife.
He was brought to the ED by ambulance. He is drowsy but can be roused. He is able to follow commands, and give answers accurately.
His eyes are deviated to the right and he is found to have left-sided complete haemianopia, severe weakness of the whole left side of his face, no movement of his left arm and leg and severe sensory deficit in the same territories, with neglect.
He is able to communicate with mild to moderate dysarthria. His CT scan showed extensive early ischaemic damage involving the whole of the right middle cerebral artery territory with a 1cm midline shift.
Some of these questions require the use of the NIHSS scoring tool. Click here for the NIHSS Score document.
What is the patient’s NIHSS score?
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Question 2 of 2
2. Question
What is the diagnosis and likely aetiology of his presentation? In addition, what initial treatment strategy should be considered?
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