Stroke investigation and management
The Investigation of stroke and Stroke management pages have been revised.
Neurology
Thrombolysis in stroke
The Thrombolystic therapy in stroke page has had a major revision to improve clarity and conciseness. Sections addressing time based and perfusion based strategies have been added.
Vertigo and walking
The Vertigo page has been updated, including some additional information about the sensitivity of an abnormal gait for a cerebellar stroke.
Nystagmus testing
The Cerebellar function page has been updated with some additional information about how to test for nystagmus.
HINTs
The Vertigo page has been updated, including some additional information about the HINTs examination.
Meningitis
The Meningitis page has been revised, with mostly wording changes to improve clarity.
Encephalitis
The Encephalitis page has been updated, including some minor changes to its epidemiology.
ASPECTs score and thrombolysis – correction
The Thrombolytic therapy in stroke page has been corrected to reflect that thrombolytic therapy is indicated with an ASPECTS score of 8 or more, not 7 or more as previously stated. Thanks to Ker for picking this up.
CT of ICA territory stroke
A CT image of an ICA occlusion territory stroke has been added to the Investigation of stroke page.
Anterior and posterior cerebral circulation
The components of the anterior and posterior cerebral circulation have been added to the Cerebrovascular diseases page.
Colour Doppler US of carotid stenosis
A colour Doppler US of carotid stenosis has been added to the Investigation of stroke page.
MRI in TGA
The Cerebral lobe function page has been updated, including additional information about transient global amnesia and MRI.
ECG of T wave inversion in SAH
An ECG demonstrating T wave inversion secondary to SAH has been added to the Investigation of subarachnoid haemorrhage page.
Investigation of SAH
The algorithm for investigation of suspected SAH on the Investigation of subarachnoid haemorrhage page has been modified to indicate that an LP may not be necessary if the initial CT is normal, and that CTA is a reasonable alternative if an LP cannot be performed.
Migraine
The Migraine page has been considerably revised and updated, particularly in the areas of epidemiology and clinical features.
Spinal links
Links between the Non traumatic causes of spinal cord disorders page and the Spinal cord injury page have been inserted.
Lateral pontine syndrome
The Stroke syndromes page has been updated with some information on the lateral pontine syndrome.
Correction – lateral medullary syndrome
There has been a correction to the segment on Lateral medullary syndrome on the Stroke syndromes page. The ipsilateral lower cranial nerve involvement has been corrected – it is lower motor neurone, not upper motor neurone as previously stated.
Callosal angle and hydrocephalus
The Hydrocephalus page has been updated, including information about the callosal angle in the diagnosis of hydrocephalus.
Causes of stroke
The Stroke page has been updated with more contemporary information about the causes of stroke following the publication of the following article. Krishnamurthi, RV, Barker-Collo, S, Parag, V, et al. Stroke Incidence by Major Pathological Type and Ischemic Subtypes in the Auckland Regional Community Stroke Studies. Changes Between 2002 and 2011 2018;49(1):3-10.