78-554: CVL may refer to: Cerebrovascular lesion, also called cerebrovascular accident or stroke Chattahoochee Valley Libraries Chinese Volleyball League , the pre-eminent men's and women's professional volleyball leagues in China from 1996 to 2017 Cytovillin , a protein Light aircraft carrier The Center for Vital Longevity Creditors' voluntary liquidation Topics referred to by
156-425: A broken bone ), air, cancer cells or clumps of bacteria (usually from infectious endocarditis ). Because an embolus arises from elsewhere, local therapy solves the problem only temporarily. Thus, the source of the embolus must be identified. Because the embolic blockage is sudden in onset, symptoms are usually maximal at the start. Also, symptoms may be transient as the embolus is partially resorbed and moves to
234-476: A diagnosis and devise the treatment plan. These data then become part of the medical record . The routine physical , also known as general medical examination , periodic health evaluation , annual physical , comprehensive medical exam , general health check , preventive health examination , medical check-up , or simply medical , is a physical examination performed on an asymptomatic patient for medical screening purposes. These are normally performed by
312-505: A medical history , a (brief or complete) physical examination and sometimes laboratory tests. Some more advanced tests include ultrasound and mammography. If done for a group of people the routine physical is a form of screening , as the aim of the examination is to detect early signs of diseases to prevent them. Although annual medical examinations are a routine practice in several countries, examinations performed on an asymptomatic patient are poorly supported by scientific evidence in
390-461: A pediatrician , family practice physician, a physical therapist , physician assistant , a certified nurse practitioner or other primary care provider . This routine physical exam usually includes the HEENT evaluation . Nursing professionals such as Registered Nurse , Licensed Practical Nurses can develop a baseline assessment to identify normal versus abnormal findings. These are reported to
468-432: A physical examination , medical examination , clinical examination , or medical checkup , a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition . It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine
546-575: A blood pressure or cholesterol, are inconclusive. A recent study found that the examination is associated with increased participation in cancer screening. Some employers require a mandatory health checkup before hiring a candidate, even though it is now well known that some of the components of the prophylactic annual visit may actually cause harm. For example, lab tests and exams that are performed on healthy patients (as opposed to people with symptoms or known illnesses) are statistically more likely to be "false positives"—that is, when test results suggest
624-444: A complete blockage of one of the carotid arteries, the risk of stroke on that side is about one percent per year. A special form of embolic stroke is the embolic stroke of undetermined source (ESUS). This subset of cryptogenic stroke is defined as a non-lacunar brain infarct without proximal arterial stenosis or cardioembolic sources. About one out of six cases of ischemic stroke could be classified as ESUS. Cerebral hypoperfusion
702-441: A different location or dissipates altogether. Emboli most commonly arise from the heart (especially in atrial fibrillation ) but may originate from elsewhere in the arterial tree. In paradoxical embolism , a deep vein thrombosis embolizes through an atrial or ventricular septal defect in the heart into the brain. Causes of stroke related to the heart can be distinguished between high- and low-risk: Among those who have
780-422: A followup after screening. The lack of good evidence contrasts with population surveys showing that the general public is fond of these examinations, especially when they are free of charge. Despite guidelines recommending against routine annual examinations, many family physicians perform them. A fee-for-service healthcare system has been suggested to promote this practice. An alternative would be to tailor
858-728: A frequency adapted to age and previous examination results ( risk factors ). The specialist American Cancer Society recommends a cancer-related health check-up annually in men and women older than 40, and every three years for those older than 20. A systematic review of studies until September 2006 concluded that the examination does result in better delivery of some other screening interventions (such as Pap smears, cholesterol screening, and faecal occult blood tests ) and less patient worry. Evidence supports several of these individual screening interventions. The effects of annual check-ups on overall costs, patient disability and mortality , disease detection, and intermediate end points such
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#1732772537888936-400: A high risk for ischemic stroke. There are two main types of hemorrhagic stroke: The above two main types of hemorrhagic stroke are also two different forms of intracranial hemorrhage , which is the accumulation of blood anywhere within the cranial vault ; but the other forms of intracranial hemorrhage, such as epidural hematoma (bleeding between the skull and the dura mater , which is
1014-413: A higher rate than those who were not. Its authors noted that studies often failed to consider or report possible harmful outcomes (such as unwarranted anxiety or unnecessary follow-up procedures), and concluded that routine health checks were "unlikely to be beneficial" in regards to lowering cardiovascular and cancer morbidity and mortality. Physical examination has been described as a ritual that plays
1092-441: A person, when asked to raise both arms, involuntarily lets one arm drift downward) and abnormal speech are the findings most likely to lead to the correct identification of a case of stroke, increasing the likelihood by 5.5 when at least one of these is present. Similarly, when all three of these are absent, the likelihood of stroke is decreased (– likelihood ratio of 0.39). While these findings are not perfect for diagnosing stroke,
1170-439: A physical examination is performed when a patient visits complaining of flu-like symptoms. These diagnostic examinations usually focus on the patient's chief complaint. General health checks, including physical examinations performed when the patient reported no health concerns, often include medical screening for common conditions, such as high blood pressure . A Cochrane review found that general health checks did not reduce
1248-488: A problem that does not exist. Disadvantages cited include the time and money that could be saved by targeted screening ( health economics argument), increased anxiety over health risks ( medicalisation ), overdiagnosis , wrong diagnosis (for example athletic heart syndrome misdiagnosed as hypertrophic cardiomyopathy ) and harm, or even death, resulting from unnecessary testing to detect or confirm, often non-existent, medical problems or while performing routine procedures as
1326-452: A problem. Its appearance makes it advisable to seek medical review and to consider prevention against stroke . In thrombotic stroke, a thrombus (blood clot) usually forms around atherosclerotic plaques. Since blockage of the artery is gradual, onset of symptomatic thrombotic stroke is slower than that of hemorrhagic stroke. A thrombus itself (even if it does not completely block the blood vessel) can lead to an embolic stroke (see below) if
1404-540: A severe headache known as a thunderclap headache ) or reveal evidence of a previous head injury . Stroke may be preceded by premonitory symptoms, which may indicate a stroke is imminent. These symptoms may include dizziness, dysarthria (speech disorder), exhaustion, hemiparesis (weakness on one side of the body), paresthesia (tingling, pricking, chilling, burning, numbness of the skin), pathological laughter, seizure that turns into paralysis, "thunderclap" headache, or vomiting. Premonitory symptoms are not diagnostic of
1482-410: A significant role in the doctor-patient relationship that will provide benefits in other medical encounters. When a physical exam is expected by the patient but is not performed by the provider, patients may express concern for the lack of depth of investigation into their illness, the validity of treatment plans and exclusions, and the doctor-patient relationship. By extension, the term "health check"
1560-428: A specialist will focus on their particular field and the nature of the problem described by the patient. Hence a cardiologist will not in routine practice undertake neurological parts of the examination other than noting that the patient is able to use all four limbs on entering the consultation room and during the consultation become aware of their hearing, eyesight, and speech. Likewise an orthopaedic surgeon will examine
1638-528: A specific Weber test and Rinne test , or it may be more briefly addressed in a cranial nerve exam. To give another example, a neurological related complaint might be evaluated with a specific test, such as the Romberg maneuver . The Old Testament makes provision for persons in the Israelite community with leprosy to be examined by a priest : if the presenting sore was white and appeared to go beyond
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#17327725378881716-432: A stroke, and may be a sign of other illness. Assessing onset (gradual or sudden), duration, and the presence of other associated symptoms are important, and premonitory symptoms may not appear at all or may vary depending on the type of stroke. Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive
1794-415: A subarachnoid hemorrhage or an embolic stroke. If the area of the brain affected includes one of the three prominent central nervous system pathways —the spinothalamic tract , corticospinal tract , and the dorsal column–medial lemniscus pathway , symptoms may include: In most cases, the symptoms affect only one side of the body (unilateral). The defect in the brain is usually on the opposite side of
1872-401: Is high blood pressure . Other risk factors include high blood cholesterol , tobacco smoking , obesity , diabetes mellitus , a previous TIA , end-stage kidney disease , and atrial fibrillation . Ischemic stroke is typically caused by blockage of a blood vessel, though there are also less common causes. Hemorrhagic stroke is caused by either bleeding directly into the brain or into
1950-400: Is a related syndrome of stroke symptoms that resolve completely within 24 hours. With the availability of treatments that can reduce stroke severity when given early, many now prefer alternative terminology, such as "brain attack" and "acute ischemic cerebrovascular syndrome" (modeled after heart attack and acute coronary syndrome , respectively), to reflect the urgency of stroke symptoms and
2028-698: Is a thorough assessment designed to evaluate an individual's overall health. So, it helps to identify any potential health risks early on. Pre-employment examinations are screening tests which judge the suitability of a worker for hire based on the results of their physical examination. This is also called pre-employment medical clearance . Some employers believe that by only hiring workers whose physical examination results pass certain exclusionary criteria, their employees collectively will have fewer absences due to sickness, fewer workplace injuries, and less occupational disease . A small amount of low-quality evidence in medical research supports this idea. Furthermore,
2106-425: Is also used for routing checks on the working of equipment or business operations or solvency . A physical examination may include checking vital signs , including temperature examination , blood pressure , pulse , and respiratory rate . The healthcare provider uses the senses of sight, hearing, touch, and sometimes smell (e.g., in infection, uremia , diabetic ketoacidosis ). Taste has been made redundant by
2184-409: Is an irritant which could potentially destroy cells since it is an acid and disrupts the normal acid-base balance in the brain. The ischemia area is referred to as the "ischemic penumbra ". After the initial ischemic event the penumbra transitions from a tissue remodeling characterized by damage to a remodeling characterized by repair. As oxygen or glucose becomes depleted in ischemic brain tissue,
2262-418: Is called stroke rehabilitation , and ideally takes place in a stroke unit; however, these are not available in much of the world. In 2023, 15 million people worldwide had a stroke. In 2021, stroke was the third biggest cause of death, responsible for approximately 10% of total deaths. In 2015, there were about 42.4 million people who had previously had stroke and were still alive. Between 1990 and 2010
2340-428: Is caused by interruption of the blood supply to the brain, while hemorrhagic stroke results from the rupture of a blood vessel or an abnormal vascular structure . About 87% of stroke is ischemic, with the rest being hemorrhagic. Bleeding can develop inside areas of ischemia, a condition known as " hemorrhagic transformation ." It is unknown how many cases of hemorrhagic stroke actually start as ischemic stroke. In
2418-504: Is different from Wikidata All article disambiguation pages All disambiguation pages Cerebrovascular accident Stroke is a medical condition in which poor blood flow to a part of the brain causes cell death . There are two main types of stroke: ischemic , due to lack of blood flow, and hemorrhagic , due to bleeding . Both cause parts of the brain to stop functioning properly. Signs and symptoms of stroke may include an inability to move or feel on one side of
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2496-442: Is less reliable in the recognition of posterior circulation stroke. The revised mnemonic BE FAST , which adds balance (sudden trouble keeping balance while walking or standing) and eyesight (new onset of blurry or double vision or sudden, painless loss of sight) to the assessment, has been proposed to address this shortcoming and improve early detection of stroke even further. Other scales for prehospital detection of stroke include
2574-409: Is the reduction of blood flow to all parts of the brain. The reduction could be to a particular part of the brain depending on the cause. It is most commonly due to heart failure from cardiac arrest or arrhythmias , or from reduced cardiac output as a result of myocardial infarction , pulmonary embolism , pericardial effusion , or bleeding. Hypoxemia (low blood oxygen content) may precipitate
2652-447: Is the second leading cause of death in people under 20 with sickle-cell anemia. Air pollution may also increase stroke risk. An embolic stroke refers to an arterial embolism (a blockage of an artery) by an embolus , a traveling particle or debris in the arterial bloodstream originating from elsewhere. An embolus is most frequently a thrombus, but it can also be a number of other substances including fat (e.g., from bone marrow in
2730-422: The cerebral cortex is involved, the central nervous system pathways can again be affected, but can also produce the following symptoms: If the cerebellum is involved, ataxia might be present and this includes: In the days before a stroke (generally in the previous 7 days, even the previous one), a considerable proportion of patients have a "sentinel headache": a severe and unusual headache that indicates
2808-650: The Los Angeles Prehospital Stroke Screen (LAPSS) and the Cincinnati Prehospital Stroke Scale (CPSS), on which the FAST method was based. Use of these scales is recommended by professional guidelines. For people referred to the emergency room , early recognition of stroke is deemed important as this can expedite diagnostic tests and treatments. A scoring system called ROSIER (recognition of stroke in
2886-487: The ventricular system , CSF or the pial surface. A third of intracerebral bleed is into the brain's ventricles. ICH has a mortality rate of 44 percent after 30 days, higher than ischemic stroke or subarachnoid hemorrhage (which technically may also be classified as a type of stroke ). Other causes may include spasm of an artery. This may occur due to cocaine . Cancer is also another well recognized potential cause of stroke. Although, malignancy in general can increase
2964-548: The 1970s the World Health Organization defined "stroke" as a "neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours", although the word "stroke" is centuries old. This definition was supposed to reflect the reversibility of tissue damage and was devised for the purpose, with the time frame of 24 hours being chosen arbitrarily. The 24-hour limit divides stroke from transient ischemic attack , which
3042-463: The 19th century, the history and physical examination were nearly the only diagnostic tools the physician had, which explains why tactile skill and ingenious appreciation in the exam were so highly valued in the definition of what made for a good physician. Even as late as 1890, the world had no radiography or fluoroscopy , only early and limited forms of electrophysiologic testing, and no molecular biology as we know it today. Ever since this peak of
3120-461: The Bamford or Oxford classification) relies primarily on the initial symptoms; based on the extent of the symptoms, the stroke episode is classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) or posterior circulation infarct (POCI). These four entities predict the extent of the stroke, the area of the brain that is affected,
3198-401: The affected joint, but may only briefly check the heart sounds and chest to ensure that there is not likely to be any contraindication to surgery raised by the anaesthetist . A primary care physician will also generally examine the male genitals but may leave the examination of the female genitalia to a gynecologist . With the clues obtained during the history and physical examination
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3276-649: The annual incidence of stroke decreased by approximately 10% in the developed world , but increased by 10% in the developing world. In 2015, stroke was the second most frequent cause of death after coronary artery disease , accounting for 6.3 million deaths (11% of the total). About 3.0 million deaths resulted from ischemic stroke while 3.3 million deaths resulted from hemorrhagic stroke. About half of people who have had stroke live less than one year. Overall, two thirds of cases of stroke occurred in those over 65 years old. Stroke can be classified into two major categories: ischemic and hemorrhagic . Ischemic stroke
3354-501: The area of the brain affected, the more functions that are likely to be lost. Some forms of stroke can cause additional symptoms. For example, in intracranial hemorrhage, the affected area may compress other structures. Most forms of stroke are not associated with a headache , apart from subarachnoid hemorrhage and cerebral venous thrombosis and occasionally intracerebral hemorrhage. Systems have been proposed to increase recognition of stroke. Sudden-onset face weakness, arm drift (i.e., if
3432-493: The arteries to the brain in those with problematic carotid narrowing , and anticoagulant medication in people with atrial fibrillation . Aspirin or statins may be recommended by physicians for prevention. Stroke is a medical emergency. Ischemic strokes, if detected within three to four-and-a-half hours, may be treatable with medication that can break down the clot , while hemorrhagic strokes sometimes benefit from surgery . Treatment to attempt recovery of lost function
3510-479: The availability of modern lab tests. Four actions are taught as the basis of physical examination: inspection , palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen). Although providers have varying approaches as to the sequence of body parts, a systematic examination generally starts at the head and finishes at the extremities and includes evaluation of general patient appearance and specific organ systems. After
3588-401: The blood supply by narrowing the lumen of blood vessels leading to a reduction of blood flow by causing the formation of blood clots within the vessel or by releasing showers of small emboli through the disintegration of atherosclerotic plaques. Embolic infarction occurs when emboli formed elsewhere in the circulatory system, typically in the heart as a consequence of atrial fibrillation, or in
3666-515: The body , problems understanding or speaking , dizziness , or loss of vision to one side . Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than 24 hours, the stroke is a transient ischemic attack (TIA), also called a mini-stroke. Hemorrhagic stroke may also be associated with a severe headache . The symptoms of stroke can be permanent. Long-term complications may include pneumonia and loss of bladder control . The biggest risk factor for stroke
3744-471: The body. However, since these pathways also travel in the spinal cord and any lesion there can also produce these symptoms, the presence of any one of these symptoms does not necessarily indicate stroke. In addition to the above central nervous system pathways, the brainstem gives rise to most of the twelve cranial nerves . A brainstem stroke affecting the brainstem and brain, therefore, can produce symptoms relating to deficits in these cranial nerves: If
3822-567: The brain and places the person at increased risk for both transient ischemic attack and major stroke in the future. Conversely, those who have had major stroke are also at risk of having silent stroke. In a broad study in 1998, more than 11 million people were estimated to have experienced stroke in the United States. Approximately 770,000 of these were symptomatic and 11 million were first-ever silent MRI infarcts or hemorrhages . Silent stroke typically causes lesions which are detected via
3900-426: The carotid arteries, break off, enter the cerebral circulation, then lodge in and block brain blood vessels. Since blood vessels in the brain are now blocked, the brain becomes low in energy, and thus it resorts to using anaerobic metabolism within the region of brain tissue affected by ischemia. Anaerobic metabolism produces less adenosine triphosphate (ATP) but releases a by-product called lactic acid . Lactic acid
3978-424: The cells of the nervous system is normally kept low by so-called uptake carriers, which are powered by the concentration gradients of ions (mainly Na ) across the cell membrane. However, stroke cuts off the supply of oxygen and glucose which powers the ion pumps maintaining these gradients. As a result, the transmembrane ion gradients run down, and glutamate transporters reverse their direction, releasing glutamate into
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#17327725378884056-486: The cost of staff health insurance will be lower. However, certain exams or tests that are requested by employers, such as a baseline low back x-ray, should not be performed, according to the American College of Occupational and Environmental Medicine. Reasons for this include the legality and medical necessity of the test as well as the inability of such testing to predict future problems, the radiation exposure to
4134-448: The depth of the skin, it was to be treated as a ritually defiling condition. A further examination was to take place seven days later. The medical history and physical examination were supremely important to diagnosis before advanced health technology was developed, and even today, despite advances in medical imaging and molecular medical tests , the history and physical remain indispensable steps in evaluating any patient. Before
4212-411: The emergency room) is recommended for this purpose; it is based on features from the medical history and physical examination. Loss of consciousness , headache , and vomiting usually occur more often in hemorrhagic stroke than in thrombosis because of the increased intracranial pressure from the leaking blood compressing the brain. If symptoms are maximal at onset, the cause is more likely to be
4290-604: The examination, whereas this practice has been subject to controversy in the age of evidence-based medicine . Several studies have been performed before current evidence-based recommendation for screening were formulated, limiting the applicability of these studies to current-day practice. Comprehensive physical exams , also known as executive physicals , typically include laboratory tests, chest x-rays, pulmonary function testing, audiograms, full body CAT scanning , EKGs , heart stress tests, vascular age tests, urinalysis, and mammograms or prostate exams depending on gender. It
4368-412: The extracellular space. Glutamate acts on receptors in nerve cells (especially NMDA receptors), producing an influx of calcium which activates enzymes that digest the cells' proteins, lipids, and nuclear material. Calcium influx can also lead to the failure of mitochondria , which can lead further toward energy depletion and may trigger cell death due to programmed cell death . Physical exam In
4446-721: The fact that they can be evaluated relatively rapidly and easily make them very valuable in the acute setting. A mnemonic to remember the warning signs of stroke is FAST (facial droop, arm weakness, speech difficulty, and time to call emergency services), as advocated by the Department of Health (United Kingdom) and the Stroke Association , the American Stroke Association , and the National Stroke Association (US). FAST
4524-402: The healthcare provider can now formulate a differential diagnosis , a list of potential causes of the symptoms. Specific diagnostic tests (or occasionally empirical therapy ) generally confirm the cause, or shed light on other, previously overlooked, causes. The physical exam is then recorded in the medical record in a standard layout which facilitates billing and other providers later reading
4602-535: The hypoperfusion. Because the reduction in blood flow is global, all parts of the brain may be affected, especially vulnerable "watershed" areas—border zone regions supplied by the major cerebral arteries. A watershed stroke refers to the condition when the blood supply to these areas is compromised. Blood flow to these areas does not necessarily stop, but instead it may lessen to the point where brain damage can occur. Cerebral venous sinus thrombosis leads to stroke due to locally increased venous pressure, which exceeds
4680-435: The importance of the physical examination, reviewers have warned that clinical practice and medical education need to remain vigilant in appreciating the continuing need for physical examination and effectively teaching the skills to perform it; this call is ongoing, as the 21st-century literature shows. People may request modesty in medical settings when the health care provider examines them. In many Western societies,
4758-412: The main organ systems have been investigated by inspection , palpation , percussion , and auscultation , specific tests may follow (such as a neurological investigation, orthopedic examination) or specific tests when a particular disease is suspected (e.g. eliciting Trousseau's sign in hypocalcemia ). While the format of examination as listed below is largely as taught and expected of students,
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#17327725378884836-496: The majority of the population. A Cochrane Collaboration meta-study found that routine annual physicals did not measurably reduce the risk of illness or death, and conversely, could lead to overdiagnosis and over-treatment; however, this article does not conclude that being in regular communication with a doctor is not important, simply that an actual physical examination may not be necessary. Some notable general health organisations recommend against annual examinations, and propose
4914-482: The need to act swiftly. During ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. There are four reasons why this might happen: Stroke without an obvious explanation is termed cryptogenic stroke ( idiopathic ); this constitutes 30–40% of all cases of ischemic stroke. There are classification systems for acute ischemic stroke. The Oxford Community Stroke Project classification (OCSP, also known as
4992-493: The notes. While elective physical exams have become more elaborate, in routine use physical exams have become less complete. This has led to editorials in medical journals about the importance of an adequate physical examination. Physicians at Stanford University medical school have introduced a set of 25 key physical examination skills that were felt to be useful. Depending upon the chief complaint , additional sections may be included. For example, hearing may be evaluated with
5070-409: The periodic medical examination are not entirely clear. They have been referenced as early as 1671. They have also been advocated for since the 1920s. Some authors point to pleads from the 19th and early 20th century for the early detection of diseases like tuberculosis , and periodic school health examinations. The advent of medical insurance and related commercial influences seems to have promoted
5148-721: The pressure generated by the arteries. Infarcts are more likely to undergo hemorrhagic transformation (leaking of blood into the damaged area) than other types of ischemic stroke. It generally occurs in small arteries or arterioles and is commonly due to hypertension, intracranial vascular malformations (including cavernous angiomas or arteriovenous malformations ), cerebral amyloid angiopathy , or infarcts into which secondary hemorrhage has occurred. Other potential causes are trauma, bleeding disorders , amyloid angiopathy , illicit drug use (e.g., amphetamines or cocaine ). The hematoma enlarges until pressure from surrounding tissue limits its growth, or until it decompresses by emptying into
5226-405: The primary care provider. If necessary, the patient may be sent to a medical specialist for further, more detailed examinations. The term is generally not meant to include visits for the purpose of newborn checks, Pap smears for cervical cancer , or regular visits for people with certain chronic medical disorders (for example, diabetes ). The general medical examination generally involves
5304-423: The production of high energy phosphate compounds such as adenosine triphosphate (ATP) fails, leading to failure of energy-dependent processes (such as ion pumping) necessary for tissue cell survival. This sets off a series of interrelated events that result in cellular injury and death. A major cause of neuronal injury is the release of the excitatory neurotransmitter glutamate. The concentration of glutamate outside
5382-428: The risk of death from cancer , heart disease , or any other cause, and could not be proved to affect the patient's likelihood of being admitted to the hospital, becoming disabled, missing work, or needing additional office visits. The study found no effect on the risk of illness, but did find evidence suggesting that patients subject to routine physicals were diagnosed with hypertension and other chronic conditions at
5460-462: The risk of stroke, certain types of cancer such as pancreatic, lung and gastric are typically associated with a higher thromboembolism risk. The mechanism with which cancer increases stroke risk is thought to be secondary to an acquired hypercoagulability . Silent stroke is stroke that does not have any outward symptoms, and people are typically unaware they had experienced stroke. Despite not causing identifiable symptoms, silent stroke still damages
5538-403: The same term [REDACTED] This disambiguation page lists articles associated with the title CVL . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=CVL&oldid=1218627986 " Category : Disambiguation pages Hidden categories: Short description
5616-422: The screening interval to the age, sex, medical conditions and risk factors of each patient. This means choosing between a wide variety of tests. The routine physical is commonly performed in the United States and Japan, whereas the practice varies among South East Asia and mainland European countries. In Japan it is required by law for regular working employees to have a health check once a year. The roots of
5694-593: The space between the brain's membranes . Bleeding may occur due to a ruptured brain aneurysm . Diagnosis is typically based on a physical exam and supported by medical imaging such as a CT scan or MRI scan . A CT scan can rule out bleeding, but may not necessarily rule out ischemia, which early on typically does not show up on a CT scan. Other tests such as an electrocardiogram (ECG) and blood tests are done to determine risk factors and possible causes. Low blood sugar may cause similar symptoms. Prevention includes decreasing risk factors, surgery to open up
5772-592: The thick outermost layer of the meninges that surround the brain) and subdural hematoma (bleeding in the subdural space ), are not considered "hemorrhagic stroke". Hemorrhagic stroke may occur on the background of alterations to the blood vessels in the brain, such as cerebral amyloid angiopathy , cerebral arteriovenous malformation and an intracranial aneurysm , which can cause intraparenchymal or subarachnoid hemorrhage. In addition to neurological impairment, hemorrhagic stroke usually causes specific symptoms (for instance, subarachnoid hemorrhage classically causes
5850-479: The thrombus breaks off and travels in the bloodstream, at which point it is called an embolus . Two types of thrombosis can cause stroke: Anemia causes increase blood flow in the blood circulatory system. This causes the endothelial cells of the blood vessels to express adhesion factors which encourages the clotting of blood and formation of thrombus. Sickle-cell anemia , which can cause blood cells to clump up and block blood vessels, can also lead to stroke. Stroke
5928-691: The underlying cause, and the prognosis. The TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification is based on clinical symptoms as well as results of further investigations; on this basis, stroke is classified as being due to (1) thrombosis or embolism due to atherosclerosis of a large artery, (2) an embolism originating in the heart , (3) complete blockage of a small blood vessel, (4) other determined cause, (5) undetermined cause (two possible causes, no cause identified, or incomplete investigation). Users of stimulants such as cocaine and methamphetamine are at
6006-407: The use of neuroimaging such as MRI . Silent stroke is estimated to occur at five times the rate of symptomatic stroke. The risk of silent stroke increases with age, but they may also affect younger adults and children, especially those with acute anemia . Ischemic stroke occurs because of a loss of blood supply to part of the brain, initiating the ischemic cascade . Atherosclerosis may disrupt
6084-463: The worker, and the cost of the exam. A physical examination may be provided under health insurance cover, required of new insurance customers. This is a part of insurance medicine . In the United States, physicals are also marketed to patients as a one-stop health review, avoiding the inconvenience of attending multiple appointments with different healthcare providers. Physical examinations are performed in most healthcare encounters. For example,
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