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INTRODUCTION

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Stroke encompasses any disease process that interrupts normal blood flow to the brain. Ischemic strokes (87%) are more common than intracerebral hemorrhage (10%) or nontraumatic subarachnoid hemorrhage (SAH) (3%) (Table 141–1). A transient ischemic attack (TIA) is a transient episode of neurological dysfunction caused by ischemia but without an acute infarction of brain tissue. TIA episodes typically lasts less than 1 to 2 hours, but duration of symptoms alone can be unreliable in discriminating between TIA and stroke as they are similar disease processes on a continuum of severity.

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Table 141-1

Stroke Classification

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CLINICAL FEATURES

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Specific findings in patients with ischemic or hemorrhagic stroke depend on the regions of the brain that are compromised and the severity of the insult (Table 141–2).

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Table 141-2

Anterior and Posterior Circulation of the Brain

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Typical symptoms of anterior cerebral artery involvement include contralateral leg weakness and sensory changes. A middle cerebral artery stroke presents with contralateral hemiparesis (arm > leg), facial plegia, and sensory loss. Aphasia is often present if the dominant hemisphere (usually left) is ...

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