Tuesday, March 6, 2012

Brachial artery embolus mimicking acute stroke

 Interesting case report: (see reference below)

"An 85-year-old woman presented to an emergency department with acute onset of right upper extremity pain and weakness. She denied sitting with her arm propped up or falling asleep in an unusual position. Her medical history included paroxysmal atrial fibrillation, hypertension, dyslipidemia, congestive heart failure, and coronary artery disease. The patient was not anticoagulated because of a recent gastrointestinal bleeding episode.
The emergency department physician diagnosed acute stroke and requested a telemedicine consultation. The patient's blood pressure was 160/70 mm Hg, and a rhythm strip demonstrated normal sinus rhythm at 80 beats per minute. On neurologic examination, the right upper extremity strength revealed no effort against gravity with some preserved strength in wrist and finger extension. The patient could not localize touch on the right arm. Findings from the remainder of the neurologic examination, including speech and language, cranial nerves, coordination, and right lower extremity strength and sensation, were normal. Reflexes and plantar responses were not tested as part of the telemedicine stroke examination in this patient. A CT scan of the brain showed normal results.
Because pain was a prominent feature of the presentation, palpation of the right upper extremity for pulses was suggested to the emergency department physician..........." 

Read full reporl here. 

E-Pearl: Brachial artery embolus mimicking acute stroke -Neurology May 3, 2011 vol. 76 no. 18 e86-e87

No comments:

Post a Comment