Note: This article is in response to West End, Pennsylvania Ambulance Services’ ‘One Breath From Death’ Campaign which NeuroEMS.com considers to be unscientific and unethical. Click here to learn more. Here’s what you need to know: 1. The initial decision to take drugs is usually voluntary and people make this choice for various reasons such as […]

Let’s start with a question which we will circle back to later: Have you ever turned red out of embarrassment, stuttered a bit around the person you had a crush on, or felt your hands tremble when you got excited or nervous? Keep that in mind, and let’s move on for now. You respond with […]

Recently we posted this case study. Highly suspicious for Bell’s Palsy (7th cranial, or facial, nerve paralysis). Let’s look at the photo below showing the facial nerve, the facial muscles it innervates, and some common signs/symptoms: Image credit   In the case study we saw right-sided paralysis and if you look at the patient’s photo […]

A 52 yof complains of chest and epigastric pain. Here is her 12 lead ECG: Image credit| Click here for larger image 50 minutes later she developed left-sided hemiplegia, facial asymmetry, deviated gaze, and left-sided neglect. (Which stroke syndrome is this indicative of?) A CT scan revealed a blockage in the R-MCA. The CT scan also indicated that the right insular cortex […]

Recall from part 1 where we discussed how common it was to observe 12 lead ECG changes in stroke patients. Now let’s look at regions deep inside your head thought to be responsible. In each hemisphere of the brain there’s a part of the cerebral cortex which folds over on itself. It’s called theinsular cortex and it […]

15-30% of strokes are cardioembolic and 60-90% of stroke patients present with ECG abnormalities. (Source) So let me ask you some questions. Is it important to obtain a 12 lead ECG during a suspected acute stroke in the prehospital setting? Why? Why not? Does it really matter either way? Before we discuss the answer… Here’s the abnormalities you’re likely to […]

Depending on what statistic you’re looking at anywhere from 30-40% of strokes result from an unknown cause. That’s right. A full work-up of these patients reveals no cardioembolic causes, no large-artery occlusive disease, and typically an absence of risk factors. It’s a diagnosis of exclusion and it’s called cryptogenic. So what actually causes these strokes to […]