Case 18

Clinical history and examination

Age: 76 years, Female.
Time of presentation: 15.30

History of event

• Symptoms: slurred speech, severe left sided weakness of which the patient seemed unaware
• Current time interval since last known well: 1 hr (60 mins)

Past medical history

• Smoker
• Lung cancer with hilar lymph node involvement
• Liver mets
• Receiving palliative radiotherapy

Relevant medications

• Prednisilone

Relevant social history

• Living circumstance: home with husband and daughter
• Prior function and care needs: independent
• Work/hobbies: retired nurse, puzzles

Examination

• Pulse: 72 reg, BP: 140/80
• Neuro:
  • Handedness: right handed
  • NIHSS: 15
  • Deficits: dysarthria, severe left face, arm and leg weakness  and neglect with field defect

Investigations requested with non imaging results