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INTRODUCTION

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.

Table 141-1

Stroke Classification

CLINICAL FEATURES

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).

Table 141-2

Anterior and Posterior Circulation of the Brain

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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