"Brain attack"

doi:10.1136/bmj.a3109

Published 1 April 2009, doi:10.1136/bmj.a3109
Cite this as: BMJ 2009;338:a3109

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"Brain attack"

S Macdonald, consultant¹, A Dixit, consultant², M G Wyatt, consultant³

¹ Interventional Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7TN, ² Stroke Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, ³ Vascular Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust

Correspondence to: M G Wyatt mike.wyatt@nuth.nhs.uk

The first 150 words of the full text of this article appear below.

A 57 year old, right handed man was seen as an emergency afteran episode of "flinging" movements of his right arm and legand slurred speech. He had no visual or sensory symptoms. Examinationshowed mild right pronator drift, and dysarthria. His symptomsresolved within 45 minutes.

Blood pressure was 135/75 mm Hg and blood sugar was normal.Electrocardiography confirmed sinus rhythm, and computed tomographyof the brain was reported as showing a well defined left cerebellarinfarct. Figure 1 shows two images of the origin of the leftinternal carotid artery.

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1 What is the patient’s ABCD2 score?

2 In fig 1

, whatdo the upper and lower carotid ultrasound imagesshow? Whatvalue of peak systolic velocity is usually quotedas indicatinga >70% stenosis, and what is the interpretationof the peaksystolic velocity in this figure?

3 What is the likely vascularterritory of . . . [Full text of this article]