Cerebrovascular accident [top]

  • Acute neurological deficit: dysphasia, hemiparesis, hemianopia
  • Deficit persists for greater than 24 hours
  • Risk factor for embolism: atrial fibrillation, ventricular thrombus, carotid artery stenosis, mechanical heart valve

Cerebellar stroke [top]

  • Sudden onset of vertigo, headache acute headache, vomiting and ataxia
  • May be complicated by loss of consciousness, brainstem signs or hydrocephalus

Subarachnoid haemorrhage [top]

  • Acute headache, very sudden onset 'like being kicked in the back of the head'
  • May be drowsy / unconscious loss of consciousness, vomiting
  • Signs of meningism:neck stiffness, photophobia
  • Acute neurological deficit

Transient ischaemic attack [top]

  • Acute neurological deficit: dysphasia, hemiparesis, hemianopia
  • Deficit resolves within 24 hours
  • Risk factor for embolism: atrial fibrillation, ventricular thrombus, carotid artery stenosis, mechanical heart valve

Extradural haematoma [top]

  • Acute or subacute neurological deficit subacute neurological deficit acute neurological deficit
  • Classical history is of head injury, particularly to the temple followed by 'lucid interval' then worsening
  • Acute headache, can cause loss of consciousness

Subdural haematoma [top]

  • Subacute or chronic neurological deficit subacute neurological deficit chronic neurological deficit
  • Fluctuating neurological signs, confusion
  • Headache, Signs of raised intracranial pressure
  • Preceding history of head injury, may be minor trauma
  • Risk factors: Anticoagulant therapy, Elderly, Alcoholics

Intracranial haemorrhage [top]

  • Acute neurological deficit: dysphasia, hemiparesis, hemianopia
  • Acute headache, vomiting
  • History of anticoagulant therapy or bleeding diathesis

Brain tumour [top]

  • Gradual onset of headache chronic headache seizure
  • Neurological deficit
  • Signs of raised intracranial pressure, papilloedema

Encephalitis [top]

  • Subacute headache
  • Confusion, fever, neurological deficit
  • May be reduced level of consciousness