1. Symptoms
   1. Immediate
      1. episodes of loss of vision
         1. left eye
      2. slumped, unable to speak
      3. headache
      4. right side face drooping
      5. right arm and leg weakness
2. Assessment
   1. Transient ischemic attack
   2. Stroke
      1. Dfn
      2. S & S
         1. Facial drooping
         2. Arm Weakness
         3. Speech Difficulty
      3. Risk Factors
      4. Types
         1. Ischemic
            1. Embolic Stroke.
            2. Thrombotic Stroke
         2. Hemorrhagic
      5. Pathophysiology
      6. Diagnosis
      7. Complications
         1. Paralysis
         2. Difficulty talking or swallowing
         3. Memory loss
         4. Emotional problems
         5. Pain
         6. Changes in behavior and self-care ability
      8. Prognosis
   3. Bell's palsy
   4. Neurosarcoidosis
   5. Multiple sclerosis
   6. Wernicke syndrome
   7. Brain tumors
3. Plan
   1. History taking
   2. P/E
   3. ECG
   4. Investigations
      1. Laboratory
         1. hematological
         2. biochemical
      2. Imaging
         1. MRI
         2. CTscan
         3. Angiography
         4. ECHO cardiogram
         5. Carotid Doppler ultrasound
      3. ECG
   5. Management
      1. Ischemic stroke
         1. Antiplatelets: Aspirin.
         2. Thrombolytic therapy: IV of tissue plasminogen activator (TPA), first 4.5 hrs
         3. Anticoagulation (Warfarin therapy)for embolic stroke.
         4. Carotid endarterectomy.
         5. Angioplasty and stents.
      2. Rehabilitation
4. Signs
   1. BP 165/100
   2. abnormal respiration
   3. left side lateralization
   4. dilated Rt pupil
   5. on neurological examination
      1. unable to speak but obeyed commands
      2. right facial drop
      3. intact visual field
      4. reduced power
         1. right arm
         2. right leg
      5. positive Baninski sign
   6. auscultation
      1. bruit of Lt carotid
5. Demographics
   1. Male, Mohammed Ali
   2. 75 yrs old
   3. retired cook
   4. hypertensive
   5. smoker, 29 cig/day for 40 yrs
      1. quit 10 yrs ago
   6. Family Hx
      1. his father died of stroke, age 65