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Windsor University School
of Medicine
Upper Cayon, St.
Kitts
Pre - Med 1 Group Discussion
Str o k e
A stroke is the rapid loss of brain function due to a disturbance in the blood supply to the brain. This can be caused by a
blockage or a hemorrhage. This is sometimes referred to as a cerebrovascular accident (CVA), or cerebrovascular insult
(CVI).
A stroke is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells
begin to die. There are two kinds of stroke: i) ischemic stroke (≈ 87%) - caused by a blood clot that blocks or plugs
a blood vessel in the brain. ii) Hemorrhagic stroke - caused by a blood vessel rupturing and bleeding into the
brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly
interrupted.
Clinical Case:
Kim is a retired nurse, visiting with family. Upon entering the family home, Kim was called to the bathroom where she met
her 75-year-old grand-mother “Nana”. Nana was hunched over on the toilet, clearly in distress while grabbing her chest.
She appears unable to speak properly. Within moments Kim recognized the signs of a stroke. What are these possible signs
and what should Kim do next?
Nana was rushed to the nearest hospital. While questioning the family the attending physician realized that “Nana” had a
history of arterial hypertension, diabetes mellitus and absolute arrhythmia. “Nana” was admitted to the neurological clinic
with symptoms of acute stroke. One hour prior, the patient had developed an acute, right-sided hemiplegia and a left-sided
facial palsy. On physical examination the patient was global aphasic, showing a left-sided eye and head deviation and
recurrent emesis. Below are possible specified treatment levels,
Treatment level 1 – In House…
1 - Given the above scenario what possible differential diagnosis has crossed your mind?
2 – What possible stop gap / temporary preservative measures could be done by the family based on your diagnosis from
point 1?
Treatment level 2 – In Patient (at the hospital)…
Nana is a 75 years old female with a history of hypertension, diabetes mellitus and absolute arrhythmia. She is admitted to
the neurological clinic unit with symptoms of acute stroke. Two hours prior, the patient had developed an acute, right-sided
hemiplegia and a left-sided facial palsy. On physical examination the patient was global aphasic, showed a left-sided eye
and head deviation and recurrent emesis. What possible treatments / tests would you recommend & Why
Treatment level 3 – Out -Patient (at home)…
A - Nana is discharged from the hospital. What possible recommendations would you implore she heed from
now on?
B – Would you have any recommendations for the family?
C – Would you advise Nana to make any dietary adjustments or lifestyle changes ?
D – Is it possible to prevent a re-occurrence of the above scenario?
October 29, 2015
