Ischemic, Hemorrhagic, lobar, hypertensive strokes

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lordman

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UW gives me a hard time and really confused me. How do you distinguish between different strokes based on course/ symptoms (headache, nausea/vomiting)?

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I'd recommend probably just reading over UpToDate. Clinically, you can't tell whether someone has had an ischemic vs hemorrhagic stroke. That's why we have to non-contrast CT first (and especially if you are considering thrombolysis in the first 3-4.5 hrs).

Hypertension is the greatest risk factor for stroke, but we can't tell where a stroke is going to be just because a patient is hypertensive. Lacunar strokes are classically more specific for hypertension, rather than emboli. A lacunar stroke will usually present with an isolated deficit without cortical dysfunction (i.e. dysphasia, visual-spacial derangement).

Headache, nausea and vomiting are non-specific. The only time these really ring a bell for me is that if they mention morning vomiting, you'd think brain tumor.
 
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