Case 16

Clinical history and examination

Age: 32 years, Male.
Time of presentation: 10:00

History of event

• Symptoms: woke at 09.00 unable to speak, right sided weakness
• Current time interval since last known well: went to bed at 02:00 well, now 8 hrs (480 mins) after last seen well

Past medical history

• Heavy smoker
• On methadone programme
• Smokes ‘’white stuff’’
• BMI: 40

Relevant medications

• Methadone

Relevant social history

• Living circumstance: hostel
• Prior function and care needs: normal independent
• Work/hobbies: unemployed

Examination

• Pulse: 120, BP: 200/120
• Neuro:
  • Handedness: unknown
  • NIHSS: 21
  • Deficits: global aphasia, deviated gaze, hemianopia, right sided weakness

Investigations requested with non imaging results