www.emtldr.com

/Neurology

For the odd patient presenting with symptoms concerning for a posterior stroke such as vertigo, ‘fogginess’ in the head and unsteady gait. This screener is also useful for patients who need a focused exam pending discharge for a posterior TIA with resolved symptoms (to ensure symptoms have resolved prior to discharge per protocol)

COPYPASTA Physical Examination for posterior stroke, written in the negative:

No Eye Signs of Vestibulocerebellar or Basilar symptoms:
– No blurred vision or diplopia
– No pathological nystagmus
– No head tilt or ocular torsion
– Normal bilateral corneal reflex
– Normal convergence.
– No gaze divergence in any direction (vertical lateral diagonal).
– PEARL

No cerebellar or brainstem medullary tract signs
– No limb ataxia
– Normal temperature and sharp touch sensation to limbs
– No hypotonia of either arm. (arm raise test)

No CN Signs
– Normal sensation to trigeminal dermatomes (CN V)
– No evidence of horner’s syndrome
– No hoarse voice. Normal voice. No suggestion of bulbar weakness.
– No difficulty swallowing.