Here is your complete CVA long case guide - everything is above, but let me give you a clean summary of how it is organized so you can navigate it:
GUIDE STRUCTURE SUMMARY
The full guide above has 8 Parts:
Part 1 - How to Walk In: What to observe before you say a word - posture, gaze deviation, facial asymmetry, equipment in the room.
Part 2 - History Taking: Detailed questions for the presenting complaint (onset timing, progression, specific deficits), past medical history (HTN, DM, AF, valvular disease, TIA), drug history, social history, family history, and a list of important negative history points you must actively ask about.
Part 3 - Examination: Step-by-step from vitals/cardiovascular → consciousness (GCS) → higher mental functions (aphasia testing) → motor (inspection, tone, power, reflexes, Babinski, coordination) → sensory → gait.
Part 4 - All 12 Cranial Nerves: For each nerve:
- Course from origin to end
- Memory hook to remember it
- Exactly what to test clinically
- What history questions to ask
- Relevant CVA findings
The most exam-critical CN point: CN VII (facial) - in a UMN (stroke) lesion the forehead is SPARED because the frontalis has bilateral cortical representation. In LMN (Bell's palsy) the entire face including forehead is involved. Examiners always ask this.
Part 5 - UMN vs LMN Table: Complete comparison with the acute UMN caveat (early stroke can be flaccid/hyporeflexic - do not miss it), plus a 5-step bedside differentiation approach.
Part 6 - Quick Cranial Nerve Course Memory Table: All 12 with foramina and key clinical point in one table.
Part 7 - CVA Syndromes: MCA, ACA, PCA, lacunar, Weber, Millard-Gubler, Wallenberg, Benedikt - what each looks like.
Part 8 - Negative Findings: Specific negative history and examination points you are expected to mention in a long case to show systematic thinking.