5. THROMBOTIC STROKE
• Onset during sleep or on rising
• Usually in elderly
• Stepwise evolution
• Preservation of consiousness
• Gradual recovery
6. • No seizure or headache
• h/o prodromal TIA’s
• Evidence of atheroscelerosis
7. EMBOLIC
• Abrupt development of completed
stroke within few seconds
• Rapid improvement within minutes or
hours
• Occur at any time
• Relative preservation of consiousness
• Occur in any age
8. • Localised headache,seizures +
• Rapid recovery
• Evidence of recent stroke
• No history of prodromal TIA
9. HEMORRHAGIC
• Presence of hypertension
• Onset during walking hours
• Headache +/_ , seizure+ , vomiting +
• Deepening stupor/ coma
• Gradual development
12. PYRAMIDAL TRACT
UMN LMN
• Weakness in the • Weakness in the spinal
corticospinal dist segment dist
• Distal muscle groups • Wasting
• Axial movts are spared
• Extraocular,upper
facial,pharyngeal,jaw
muscles are spared
13. • Hypertonia • Hypotonia
• Exaggrated tendon • Loss of tendon reflex
reflex • Muscle wasting
• No muscle wasting • Fasciculation &
• Extensor plantar contracture of affected
response muscle
• Loss of abdominal • Trophic changes in skin
reflexes nail
14. What the patient complaints off ????
• Stiffness of legs
• Unable to walk on rough ground
• Diff.to climb stairs
• Vibration of limb while stepping down
the stairs- ankle conus
• Finally,dragging of foot,stiff legged
gait,keeps tripping over,shoes wearing
off
15. Features of
extrapyramidal lesion
• Difficulty to initiate voluntary movt
• Hypertonia-rigidity
• No loss of power of muscles
• Bradykinesia
• Inv movts
• Postural instability