Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). General Inspection During the general inspection of the cranial nerves, we should look for whether the patient has any ptosis, abnormal eye movements and facial asymmetry. We should also inspect for whether there are any neuro-cutaneous features (for example in patients…
Dense middle cerebral artery sign There are a number of radiological features that can be seen in the non-contrast CT scan which support the clinical suspicion of an ischaemic stroke. One of the early ischaemic changes that could be recognized on a non-contrast CT film is the “dense middle cerebral artery (MCA) sign“. As you can…
Bilateral watershed infarct The non-contrast CT brain shown is from a patient with bilateral watershed infarct. Here, chronic ischaemic changes can be seen along the external or cortical watershed zones (Figures 1 and 2). These “borderzones” is where the terminal vasculature of the anterior cerebral artery and middle cerebral artery meet as well as where the middle…
There are a number of ways of classifying ischaemic stroke. One of them is by anatomical classification e.g. anterior versus posterior circulation, the precise artery involved (e.g. left middle cerebral artery infarction) or the structure affected (e.g. right pontine infarct). It can also be classified according to the underlying etiology. A commonly used classification system is the TOAST…
Ischaemic stroke with haemorrhagic transformation, also known as haemorrhagic infarct, occurs in approximately one-third of cases of ischaemic stroke. Haemorrhagic infarct occurs more commonly in the elderly, those with larger infarcts as well as those having received thrombolytic therapy. The mechanism of haemorrhagic infarct has been postulated to be due to the breakdown of the basal…