Cases for finals #12 – history

19 year old medical student:

  • out celebrating the end of neuro teaching
  • wakes up in morning with right arm weakness
  • can’t grip anything
  • totally looses it and calls 999 ?stroke

A summary from the history might be:

“An acute neurological disorder characterised by  unilateral right arm weakness”

So, is this a stroke?

Well from the history it could be. The history is of an acute onset focal neurological deficit which is certainly in keeping with a vascular problem.

There are some things that don’t quite fit though. For example, the patient is 19 which isn’t the typical demographic for stroke.

What would you be looking for in the examination?

What else could this be apart from a stroke?

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