Transient monocular blindness.

A body image disorder in which the patient neglects or fails to recognize part of his or her own body.

Usually takes the form of unilateral neglect.

Caused by a parietal lobe lesion.

The patient tends not to use the contralateral limbs, may deny that there is anything wrong with these limbs, and may even fail to recognize the contralateral limbs.

Fluent speech and excellent comprehension.

Unable to name fingers and body parts nor to determine right or left orientation.

Unable to write down thoughts and take notes.

Good reading comprehension.

Unable to do calculations.

Location is the inferior frontal convolution, including the Broca area.

Impaired fluency of spontaneous speech.

Toxoplasmosis.

Lymphoma.

Insidious onset. Slowly progressive course.

Diplopia, ptosis, dysarthria, extremity weakness, generalized weakness, dysphagia.

Weakness does not conform to the distribution of any single nerve.

Pupillary responses are not affected. Persistent activity of a muscle group leads to temporarily increased weakness, with restoration of strength after a brief rest.

Weakness, paralysis, spasticity.

Increased tendon reflexes, positive Babinski reflex.

No significant muscle atrophy.

Risk of hemorrhage:

Prior intracranial hemorrhage; seizure at the onset of stroke symptoms; stroke or trauma occurring less than 3 months before the presenting stroke; a major surgical procedure within 14 days; gastrointestinal or urinary tract bleeding
within 21 days; systolic blood pressure over 185 mm Hg or diastolic blood pressure over 110 mm Hg; current treatment with warfarin for atrial fibrillation.

To avoid unnecessary treatment:

Do not give tPA if neurologic deficits are improving rapidly and spontaneously; if deficits are mild and isolated; in the presence of hypo- or hyperglycemia (which can cause symptoms mimicking a stroke); when symptoms have begun more than 3 hours before the proposed tPA therapy.