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Neuro missing > 10- stroke > Flashcards

10- stroke Flashcards

1
Q

3 types of stroke

A
  • ischaemic (thromboembolic)
  • haemorrhagic (intracerebral or subarachnoid)
  • dissection/venous sinus thrombosis/hypoxic brain injury
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2
Q

2 main principles of stroke management

A
  • within thrombolysis window (4 hours)

- determine if bleed with CT scan

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3
Q

how to image stroke

A
  • CT shows blood as bright white

- MRI shows ischaemia as high signal areas

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4
Q

symptoms anterior cerebral artery infarct

A
  • contralateral lower limb weakness
  • contralateal sensory changes
  • urinary incontenence (paracentral lobules)
  • apraxia (left frontal)
  • dysarthria/aphasia (frontal lobe)
  • split brain (corpus callosum)
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5
Q

stroke definition

A

neurological deficit caused by injury of CNS by vascular cause, including cerebral infarction, intracerebral haemorrhage or SAH

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6
Q

TIA definition

A

transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischaemia without acute infarction

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7
Q

risk factors stroke

A

HT, smoking, DM, heart disease, TIA, carotid bruit, PCV, COAC, alcohol, clotting disorders

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8
Q

what is apraxia

A

inability to complete motor planning

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9
Q

symptoms proximal MCA infarct

A

-all branches (lenticulostriate/distal) affected

  • contralateral hemiparesis (due to internal capsule is affected)
  • contralateral sensory loss (face and arm, can be more if internal capsule affected)
  • contralateral homonymous hemianopia without macula sparing as both superior and inferior optic radiations are destroyed
  • global aphasia
  • contralateral neglect (right parietal lobe)
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10
Q

what is contralateral neglect

A

cannot acknowledge the other side of the body

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11
Q

distinguishing feature of lenticulostriate stroke

A

does not cause cortical features eg. neglect of aphasia

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12
Q

what is a lenticulostriate stoke

A

lentoculostriate artery occluded, lacunar stroke. destruct internal capsule and basal ganglia

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13
Q

types of MCA lenticulostrate/lacunar occlusion

A

pure motor
pure sensory
sensorimotor

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14
Q

presentation of distal MCA occlusion

A

superior division
-contralateral face and arm weakness and expressive aphasia (Broca’s and PMC)

inferior division
-contralateral face and arm sensory loss. receptive aphasia and homonymous hemianopia (wernickes, PSC and both optic radiations)

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15
Q

presentation posterior cerebral artery

A

contralateral homonymous hemianopia with macular sparing (due to collateral MCA supply)
contralateral sensory loss due to thalamus damage

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16
Q

symptoms cerebellar infarcts

A

vomiting, nausea, headaches, vertigo,

DANISH (ipsilateral cerebrellar signs),

ipsilateral brainstem signs as cerebellar arteries supply brainstem as they loop around the cerebellum.

contralateral sensory deficit/ipsilateral corners

17
Q

presentation brainstem strokes

A

contralateral limb weakness with ipsilateral cranial nerve signs du to damage to corticospinal tracts above desiccation of pyramids, and damage to cranial nerve nuclei on dame side

18
Q

presentation of distal basilar artery occlusion

A

-sudden death as supplies brainstem

distal

  • visual and oculomotor deficits
  • behavioural abnormalities
  • somnolence, hallucinations and dream like behaviour
  • motor dysfunction absent
19
Q

presentation of proximal basilar artery occlusion

A

at level of pontine branches

  • locked in syndrome
  • eyes can still move as midbrain still has PCA supply
20
Q

what are the 4 things on the Oxford stroke classification

A

PACS, TACS, POCS, LACS

21
Q

PACS

A

PARTIAL ANTERIOR CIRCULATION STROKE

2 OF: unilateral weakness of face arm and leg, homonymous hemianopia, dysphasia/aphasia or visuospatial disorder

22
Q

TACS

A

TOTAL ANTERIOR CIRCULATORY STROKE

unilateral weakness of face arm and leg, homonymous hemianopia, dysphasia/aphasia or visuospatial disorder

23
Q

LACS

A

LACUNAR STROKE/LENTICULOSTRIATE

  • pure sensory deficit
  • pure motor deficit
  • senori-motor deficit
  • ataxic hemiparesis
24
Q

POCS

A

POSTERIOR CIRCULATION STROKE- one of

  • cranial nerve palsy and contralateral motor/sensory deficit
  • bilateral motor/sensory deficit
  • conjugate eye movement disorder
  • cerebellar dysfunction
  • isolated homonymous hemianopia with macula sparing
25
Q

what is the key sign for brainstem pathology

A

ipsilateral cranial nerve signs and contralateral sensory and motor tract deficits

Neuro missing (19 decks)

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