MedBugs: SAQ #617

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Case: Dizziness and Vomiting

A 73-year-old woman presents with dizziness and vomiting for 12 hours. You are concerned that she may have a posterior circulation stroke.

1. List 4 features on clinical examination that would support a central cause for her symptoms. 4 marks

You are concerned that the patient may have a posterior circulation stroke.

2. List 4 examination findings that would be consistent with lateral medullary syndrome. 4 marks

3. Describe the CT abnormality and name the blood vessel that supplies this area. 2 marks

The patient is admitted under neurology and deemed not eligible for reperfusion therapy. She remains in the ED awaiting telemetry bed. 12 hours later she is noted to have a rapid fall in her level of consciousness.

4. State a possible cause for her clinical deterioration related to the abnormality demonstrated on CT scan. 1 mark

5. What is the treatment of this complication? 1 mark

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