15 Strokes

Question 1

Differentiate between a Stroke and a TIA.

Answer 1

Stroke

• includes infarction and haemorrhage
• neurological deficit rather than transient episode

Question 2

What are the different causes of a stroke? What is the most common?

Answer 2

1. ischaemic (85%)
2. haemorrhagic (10%)
3. other (5%)

Question 3

Give some differential diagnoses for strokes in young and old people.

Answer 3

Question 4

List some risk factors for a stroke.

Answer 4

1. Hypertension
2. Heart failure
3. Clotting disorder
4. Smoking

Question 5

What is an MMSE used for? (mini mental state exam)

Answer 5

Test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual-spatial skills

Question 6

What is the PHQ-9 test used to assess? (Patient health questionnaire)

Answer 6

• Used to monitor the severity of depression and response to treatment.
• However, it can be used to make a tentative diagnosis of depression in at-risk populations - eg, those with coronary heart disease or after stroke

Question 7

What might the signs be for a stroke affecting the anterior cerebral artery? (5)

Answer 7

1.

Question 8

Which artery is a stroke in the middle cerebral artery likely to have come from?

Answer 8

Internal carotid artery

Question 9

What might the signs be for a stroke affecting the proximal middle cerebral artery?

Answer 9

Question 10

What signs might you get from an occlusion of one of the lenticulostriate arteries?

Answer 10

Depends which artery- lacuna stroke as small arteries

Will affect part of the internal capsule

Rememeber FAL fal (motor then sensory)

Question 11

Which part of the brain do each of the cerebral arteries supply?

Answer 11

Question 12

What might be the signs for a stroke affecting the posterior cerebral artery?

Answer 12

Question 13

Why are you likely to get macular sparing with a posterior cerebral artery stroke that has affected the primary visual cortex?

Answer 13

Question 14

What might be the signs for a stroke affecting the cerebellar arteries?

Answer 14

Question 15

What 3 signs will a patient with an TACS (total anterior circulation stroke) have?

Answer 15

1. Unilateral weakness (+/- sensory deficit) of face, arm and leg
2. Homonomous hemianopia
3. Higher cerebral dysfunction
   
   1. _​_Dysphasia/aphasia
   2. Visuospatial disorder

Question 16

What signs will a patient with an PACS (partial anterior circulation stroke) have?

Answer 16

2 of:

• Unilateral weakness(+/- sensory deficit) of face, arm and leg
• Homonomous hemianopia
• Higher cerebral dysfunction
  
  • ​Dysphasia/aphasia
  • Visuospatial disorder

Question 17

What signs will a patient with an POCS (posterior circulation stroke) have?

Answer 17

One of:

1. Cranial nerve palsy and contralateral motor/sensory deficit
2. Bilateral motor/sensory deficit
3. Conjugate eye movement disorder
4. Cerebellar dysfunction
5. Isolated homonomous hemianopia (with macular sparing)

Question 18

What signs will a patient with an LACS (lacunar syndrome) have?

Answer 18

One of the following:

1. Pure sensory deificit
2. Pure motor deficit
3. Senory-motor deficit
4. Ataxic hemiparesis (weakness and ataxia on same side)

Question 19

Describe the type of hemiparalysis that might be seen in a stroke in the proximal middle cerebral artery?

Answer 19