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?