QuestionSBA
QuestionChoice
This is described as a rapid, transient loss of consciousness followed by a spontaneous, complete recovery.

Causes can be due to emotion or stress which is referred to as reflex syncope or fainting. Other causes include low blood pressure, bradycardia and other arrhythmias.

There is no loss of consciousness in this case so can be ruled out.
10005792
b
Syncope
QuestionChoice
This type of stroke is caused by the rupture of aneurysms within the brain. This can be spontaneous but risk factors include hypertension, drug use, age or trauma.

stroke is a clinical syndrome characterised by rapid focal disturbance of cerebral function. This can include motor weakness, sensory loss, speech and swallowing impairment.

When a patient presents with these features an urgent CT scan is required to confirm the diagnosis and guide further management. This is important as you cannot tell the difference between ischaemic strokes from haemorrhagic strokes just from the clinical picture.
10005793
c
Haemorrhagic Stroke
QuestionChoice
Presents with similar symptoms of a stroke but is less than 24 hours. The episodes usually last about an hour and have resolved by the time they seek medical attention.

These patients should be taken seriously as TIA can increase the risk of stroke in the future.

Refer to a TIA stroke clinic for urgent assessment in 24 hours if this is suspected. Do not discharge with no follow-up.
10005791
a
Transient Ischaemic attack (TIA)
QuestionChoice
According to the Monro-Kellie doctrine of ICP, the skull is a fixed box and there is an equilibrium between the CSF, blood and brain. If one of these components increases in volume another would have to decrease to compensate.

When there is too much change in volume and compensatory mechanisms fail, the ICP can quickly increase and cause displacement of the brain parenchyma.

This presentation can include headaches, stiff neck, slow pulse, weakness and loss of consciousness. This can be very serious and deteriorate quickly.

Focal neurological deficits aren't usually seen.
10005795
e
Brain herniation
QuestionChoice
This refers to the inflammation of the meninges that surround the brain.

This usually presents with confusion, fevers, headache and neck stiffness.

Focal neurological deficits aren't usually seen but if encephalitis has developed, this could be elicited on examination
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d
Meningitis
Concept
Chapter
2693
4448
Transient Ischaemic Attack
Topic
141
Neurology
13705
80 year old attends the emergency department distressed saying he has had a stroke.

He begins to explain that he has experienced an episode of facial drooping and arm weakness on the same left side. This began 2 hours ago and was resolved within 15 minutes. There was some vision loss during this time but resolved at the same time as the weakness.

There was no loss of consciousness.

On examination he seems alert and orientated, his vital signs are normal with no fever.

What is the likely diagnosis?
a