Case 07

Clinical history and examination

Age: 52 years, Male.
Time of presentation: 11:15

History of event

• Symptoms: difficulty speaking, left arm and leg weak, unable to stand – no migraine features
• Current time interval since last known well: 1 hr (60 mins)

Past medical history

• Migraine with aura
• Excess use of alcohol

Relevant medications

• None

Relevant social history

• Living circumstance: at home, alone – recently separated
• Prior function and care needs: normally independent, driver
• Work/hobbies: recently made redundant from sales job

Examination

• Pulse: 68 BP: 134/82
• Neuro:
  • Handedness: left handed
  • NIHSS:  8
  • Deficits: face asymmetric, speech non fluent, unable to keep either arm or leg off bed

Investigations requested with non imaging results