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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The hallmark of the embolic stroke is the rapidity of onset. Typically, without warning, the patient collapses to the floor, conscious, but hemiplegic. Seizures are common. Headache and vomiting are rare.

Emboli lodged in the junction of the vertebral arteries results in brain stem infarction. Entrapment at the upper end of the basilar artery produces unilateral or bilateral visual disturbance.

Look for:

  • visual loss - permanent or transient eg. amaurosis fugax
  • hemisensory and hemimotor disturbance
  • disturbance of higher function eg. dysphasia
  • focal or generalised seizures
  • aortic emboli may involve both hemispheres and produce bilateral signs
  • more precise effects depend upon the area occluded

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