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What a stroke


Ansari, Umair & Crampton, James (2005). What a stroke. BMJ, 331(7515), 513.


A 64 year old man, who lived alone, was found collapsed one morning by his daughter. He responded only to painful stimuli and seemed to have weakness of the left side of his body. He was brought by ambulance to the accident and emergency department, the paramedics alerting the department that they were bringing a patient with stroke. On arrival at the department, the patient's Glasgow coma scale was 10/15. He was not moving the left side of his body, although tone was normal in both arm and leg and power could not be assessed because of his low Glasgow coma scale. He had equivocal plantar responses and pinpoint pupils. We diagnosed pontine haemorrhage and arranged for computed tomography as we assumed that he had weakness of the left side of the body.

While waiting for the computed tomography, we thought that the pinpoint pupils could be an indication of an opiate overdose. We therefore gave the patient 400


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Ansari, Umair
Crampton, James