Clinical case Stroke

•A 66-year-old man was brought to the emergency department after the sudden onset of hemiplegia and aphasia.

•The patient had been well until approximately 2 hours before presentation, when severe weakness developed on the right side and he lost the ability to speak.

•He had a right facial droop and was unable to lift his right arm

•¿With only this information, could you tell me the laterality of the lesion?

• A.The injury very likely occurred on the Left side

• A.The injury very likely occurred on the Right side

This patient has the following finding on the physical examination. What type of facial palsy does this patient have?

• A.Central facial Palsy

• A.Peripheral facial palsy

You take an electrocardiogram of this patient, ¿what is your interpretation?

• A.Synus rhythm

• A.Right bundle branch block

• A.Atrial fibrillation

• A.Atrial flutter

•According to the ABCDE system for managing patients in emergency departments, What is the key diagnostic test during the initial assessment of this patient?

• A.CT (Computed tomography)

• Capillary blood glucose level

• ECG

• A.MRI (magnetic resonance imaging)

This patient underwent the NIHSS scale, which yielded a score of 14 points. The ASPECTS scale was also conducted, resulting in a score of 10 points on that scale. Taking this into account along with the patient's clinical presentation, what type of management is indicated for this patient? time that the patient had last been well (2 HOURS)

• Alteplase 0.9 mg/kg (maximum dose of 90mg) over 60 minutes. 10% is given as a bolus, and 90% is given as an infusion over one hour.

• Mechanical thrombectomy, because it is outside the time window.

• It does not have an indication for management because it is outside the time window.