Stroke is a heterogeneous group of conditions with many causes, levels of severity and clinical presentations. If a patient presents with an acute onset of focal neurologic deficit during the prior week without preceding head trauma, the odds of a stroke increase over 90-fold. Clinical findings may suggest the type of stoke, but precision is poor and requires an imaging study to differentiated between ischemic and hemorrhagic strokes. The level of consciouslness is the single strongest predictor of short term survival. Asymptomatic carotid bruits increase with age and are not predictive of an increased risk of perioperative stroke, and only mildly increases the probability that the underlying stenosis is high -grade requiring endarterectomy.
Ultrasound visualization is required to assess the severity of stenosis.
If a spleen is palpated then it splenomegaly is established. If palpation is negative a scan is required to rule out splenomegaly. Diagnosing acute sinusitis by history and physical examination. Maxillary toothache, poor response to nasal decongestants, abnormal transillumination and colored nasal discharge are the most useful clinical findings. When all five features are present the odds of sinusitis are markedly increased and when none is present sinusitis is virtually ruled out.