Different strokes : a management dilemma

• Published in: Sultan Qaboos University medical journal Vol. 18; no. 2; pp. 202 - 207
• Main Authors: Kakaria, Anupam K., al-Asimi, Abd Allah Rashid, Lal, Darshan, al-Tijani, Murtada, Gujjar, Arunodaya R.
• Format: Journal Article
• Language: English
• Published: Muscat, Oman Sultan Qaboos University, College of Medicine and Health Sciences 01-05-2018; Sultan Qaboos University; Sultan Qaboos University Medical Journal, College of Medicine & Health Sciences
• Subjects: Blepharoptosis - etiology; Blood pressure; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - etiology; Cerebral Small Vessel Diseases - complications; Cerebral Small Vessel Diseases - diagnostic imaging; Continuing Medical Education; Disease prevention; Family medical history; Female; Hemorrhage; Humans; Hypertension; Hypertension - complications; Hypertension - drug therapy; Intracranial Hemorrhage, Hypertensive - diagnostic imaging; Intracranial Hemorrhage, Hypertensive - etiology; Magnetic Resonance Imaging; Middle Aged; Neurological disorders; Neurology; Oculomotor Nerve Diseases - complications; Oman; Ophthalmoplegia - diagnosis; Ophthalmoplegia - etiology; Pain - etiology; Paresis - diagnosis; Paresis - etiology; Patients; Stroke; Stroke - classification; Stroke - complications; Stroke - diagnostic imaging; Stroke, Lacunar - complications; Stroke, Lacunar - diagnostic imaging; Tomography, X-Ray Computed; Oman; Germany; Continuing Medical Education; Cerebral Small Vessel Disease; Stroke; Lacunar Stroke; Cerebral Hemorrhage
• ISSN: 2075-051X; 2075-0528
• DOI: 10.18295/squmj.2018.18.02.013

Stroke is a common medical emergency resulting from numerous pathophysiological mechanisms
and with varied clinical manifestations; as such, the diagnosis of stroke requires diligent clinical assessment.
When different stroke syndromes occur in the same patient, it may cause a dilemma in terms of diagnosis and
management. This continuing medical education article describes an interesting patient with recurrent neurological
events, highlighting the complex pathophysiological processes associated with cerebrovascular syndromes. It offers
readers the opportunity to apply their own basic neuroscience knowledge and clinical skills to solve the challenges
encountered during the course of diagnosing and treating this patient. Specifically, the article aims to familiarise
readers with an approach to diagnosing brainstem strokes and the diverse manifestations of a common stroke
syndrome.