What kind of symptoms are patients
going to 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 let's discuss typical symptoms
for each occluded artery.
If there is an occlusion of
the middle cerebral artery,
you can find
contralateral sensory loss
and paralysis in the arms,
lower half of the face and lower limbs.
The gaze might deviate towards
the side of the infarction.
A contralateral homonymous hemianopia
without a macular sparing might be present
or you could see Broca's
aphasia or Hemineglect.
Next, let's look at clinical features of
an Anterior Cerebral Artery occlusion.
First, there could be a
more in the lower than
in the upper limbs.
Also a minimal sensory loss,
again more in the lower than
in the upper limbs is possible,
and then there are typical
symptoms such as Dysarthria,
Aphasia, limb apraxia
or urinary incontinence.
Lastly, there are the clinical features
of a posterior cerebral artery occlusion.
There can be visual
For example a contralateral homonymous
hemianopia with mascular sparing.
Also a contralateral
hemisensory loss is possible
due to the lateral
as well as memory deficits.
If there is an involvement
of the left PCA territory,
you can get symptoms such
as alexia without agraphia,
Anomic Aphasia or
An involvement of the right PCA
territory could lead to prosopagnosia.
The other very important thing that you want
to 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 want
to know the time of onset
is because it will affect what treatment
you're able to give your patient
and it will affect
whether or not you're able
to give your patient
We always want to make sure that
we urge people and tell patients
that right from when they're
experiencing a stroke symptoms
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
there were able to
intervene on their stroke
and to give a medication
called TPA or a thrombolytic
to help break up
that blood clot.
We will talk more about that when we
talk about the treatment of stroke.