note about CVA , very intersting and very useful for student and doctors contain proper way to compose and take very nice history and guidance to dignosis

1. بسم الله الرحمن الرحيم CVA Academic group OF internal medicine - Revision note of CVA- 2010 Dr. Mohamed Eisam Elhag Mahmoud MBBS, Alneelain University Faculty of Medicine Note: Dr. Mohammed Isam Al-Hajj does not have any financial relationships to disclose nor will he discuss any non-approved drug or device uses.

33. Q- what is the nature of lesion? Haemorrage Infraction embolism thrombosis Dramatic onset Occure when pt in his/her ordinary activity Sudden onset with max. intensity at the begin Rapid onset when pt. weak up from sleep then within hours weakness at maximum onset. Also condition associated with: Vomiting Convulsion fever Usually there is clear source of embolism. Ex. . cardiac -> preceded palpitation . Fat embolism ” bone fracture” . air embolism . pulmo. Embolism -> VSD “paradoxical embolism” Source: . HF . MI

40. Thank you for your attention Now start of OSCE…..

41. www.smso.net Best whishes أليس الماضي و عبق التاريخ يا رمز النضال لؤلؤة النيل حورية الضفاف باهية الجمال هواك يناديني فأهرع عبر المدائن و البوادي و التلال

44. BRAIN ABSCESS

45. EPIDURAL HEMATOMA

46. SUBDURAL HEMATOMA

54. What is this Condition? Ramsay Hunt Syndrome

61. Retina Optic Nerve LGB Optic radiation Chiasma Lower fibres (Temp lobe) Upper fibres (ant parietal lobe) Occipital Cortex

62. Retina Optic Nerve LGB Optic radiation Chiasma Lower fibres (Temp lobe) Upper fibres (ant parietal lobe) Occipital Cortex

63. Retina Optic Nerve LGB Optic radiation Chiasma Lower fibres (Temp lobe) Upper fibres (ant parietal lobe) Occipital Cortex

64. CN II:

65. Optic Nerve Lateral Geniculate Body Pretectal Nucleus Edinger – Westphal Nucleus of III Convergence Centre Cilliary Ganglion Cilliary Body - Iris Afferent Pathway Efferent Pathway

67. Extra Ocular Eye Muscles

71. Important causes of isolated third nerve palsy Idiopathic - about 25% Vascular disease - hypertension, diabetes Posterior communicating aneurysm Trauma Extradural haematoma Prolapsing temporal lobe Edge of tentorium Aneurysm Chiasm Third nerve Posterior cerebral artery Midbrain pushed across

75. Recent right sixth nerve palsy Right esotropia in primary position due to unopposed action of right medial rectus Marked limitation of right abduction due to right lateral rectus weakness

77. Left VI Nerve Palsy (lateral Rectus)