What kind of symptoms are patients gonna be presenting with
when they come to the hospital with concern for stroke?
So the symptoms may start very suddenly or they may be stuttering.
So stuttering means that they may start
and then gradually get a little bit more frequent in nature.
The symptoms are gonna be related to the area of the brain
in which the blood flow is occluded.
So common culprits here.
The middle cerebral artery is a large blood vessel
that supplies a big portion of the brain.
The main things we’re gonna see
when the middle cerebral artery is occluded
are motor and sensory disturbances.
So the patient is gonna have weakness as well as sensory changes.
The anterior cerebral artery will affect the frontal lobe
and in these patients, one of the classic hallmarks are that the leg
will be weaker than the arm when patients present with these symptoms.
And then the posterior circulation.
That’s the posterior portion of the brain.
Those patients can have cranial nerve deficits
because the posterior circulation supplies the brainstem.
They can also have nausea and vomiting, vision issues, and vertigo.
Posterior circulation strokes pose a significant problem
because they can be very challenging to identify,
especially in patients who present with dizziness.
So when your patient comes in with vertiginous symptoms
and what we mean by vertigo is that they describe either themselves or the room spinning,
you wanna make sure you’re thinking about whether or not
that’s a posterior circulation stroke.
The other very important thing
that you wanna try and get from either the patient or the EMS providers,
or possibly their family is the timing of onset.
The main reason that we wanna know the time of onset
is because it will affect what treatment you are able to give your patient
and it will affect whether or not
you’re able to give your patient thrombolytic therapy.
We always wanna make sure that we urge people
and tell patients that right from when they’re experiencing stroke symptoms,
that they should try and get to the hospital as quickly as possible
because the earlier they get to the hospital,
the more likely it will be that we’re able to intervene on their stroke,
and to give a medication called tPA or a thrombolytic
to help break up that blood clot.
We’ll talk more about that when we talk about the treatment of stroke.