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Clinical Hot Topics: Posterior Stroke Syndromes: When Dizziness can Mean Business

Posted on Wed, Oct 29, 2014
Clinical Hot Topics: Posterior Stroke Syndromes: When Dizziness can Mean Business

Hosted by Al Sacchetti, MD, FACEP as moderator, Don’t Blink or You Will Miss It - Clinical Hot Topics can feel much like the “speed dating” of training presentations. The 12 hyper-paced presentations covered a wealth of information for the 2014 EmCare Leadership Conference attendees.  Each week, we’ll publish highlights from select clinical hot topics presented at the conference.

Posterior Stroke Syndromes: When Dizziness can Mean Business
By Brad Hoover, MD


Nowhere is it more evident that medicine is an art than in the arrival at the clinical diagnosis. Studies have revealed that 82.5 percent of physicians could have made the diagnosis on history alone, though they acknowledge the physical exam can be useful, and testing is needed when the patient’s history and exam are unrevealing. (Hampton, et Al.: BMJ 1975)

Diagnosing posterior stroke has its challenges, and it is important to take advantage of technology to define the severity and location of lesions. Both CT and MRI scans can be helpful, but it is recommended that physicians consider MRI regardless of a negative CT. 

Here are five tips for detecting posterior stroke:

  • History: past medical, social, family
  • Response to meclizine: no matter
  • Consider MRI regardless of negative CT
  • Neurology consultation
  • Walk the patient before releasing

 

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