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ANKI Neuro > [2] Stroke Classification > Flashcards

[2] Stroke Classification Flashcards

1
Q

What are the two major types of stroke?

A
  • Ischaemic

- Haemorrhagic

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2
Q

What % of strokes are ischaemic?

A

87%

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3
Q

What % of strokes are haemorrhagic?

A

13%

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4
Q

What is an ischaemic stroke?

A

Reduced blood supply to an area of the brain resulting in tissue hypoperfusion

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5
Q

What can be the underlying mechanisms leading to ischaemic stroke?

A
  • Embolism
  • Thrombosis
  • Systemic hypoperfusion
  • Cerebral venous sinus thrombosis
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6
Q

How can an embolism cause ischaemic stroke?

A

Embolus from another part of the body (e.g. heart) obstructs a cerebral vessel resulting in hypoperfusion

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7
Q

What condition can commonly lead to embolic ischaemic stroke?

A

AF

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8
Q

How does thrombosis lead to ischaemic stroke?

A

Local formation of a blood clot in a cerebral vessel

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9
Q

What is the most common cause of thrombosis leading to ischaemic stroke?

A

Rupture of an atherosclerotic plaque

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10
Q

How can systemic hypoperfusion lead to ischaemic stroke?

A

Systemic hypotension leads to reduced blood supply

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11
Q

When can systemic blood pressure drop low enough to cause systemic brain hypoperfusion leading to ischaemic stroke?

A

Cardiac arrest

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12
Q

How can cerebral venous sinus thrombosis lead to ischaemic stroke?

A

Blood clots form in the veins that drain the brain leading to congestion and hypoxia damaging brain tissue

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13
Q

When does haemorrhagic stroke occur?

A

When there is rupture of a blood vessel or abnormal vascular structure in the brain

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14
Q

What are the two subtypes of haemorrhagic stroke?

A
  • Intracerebral haemorrhage

- Subarachnoid haemorrhage

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15
Q

What is an intracerebral haemorrhage?

A

Bleeding within the brain itself secondary to ruptured blood vessel

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16
Q

What are the subtypes of intracerebral bleed?

A
  • Intraparenchymal

- Intraventricular

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17
Q

What is intraparenchymal bleeding?

A

Bleeding in the brain tissue

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18
Q

What is intraventricular bleeding?

A

Bleeding in the brain ventricles

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19
Q

What is a subarachnoid haemorrhage?

A

Bleeding that occurs outside of the brain tissue, between the pia mater and the arachnoid mater

20
Q

What is the most common underlying cause of a subarachnoid haemorrhage?

A

Rupture of berry aneurysm

21
Q

What are the three main (pairs of) arteries that supply the cerebrum?

A
  • Anterior cerebral arteries
  • Middle cerebral arteries
  • Posterior cerebral arteries
22
Q

What region of the cerebrum is supplied by the ACA?

A

Anteromedial area

23
Q

What area of the brain is supplied by the MCA?

A

Lateral cerebrum

24
Q

What area of the brain is supplied by the PCA?

A

Medical and lateral areas of the posterior cerebrum

25
Q

What lobes of the brain are supplied by the ACA?

A
  • Medial part of the frontal lobe

- Superior-medial parietal lobe

26
Q

What lobes of the brain are supplied by the MCA?

A
  • Lateral frontal lobe
  • Lateral temporal lobe
  • Lateral parietal lobe
27
Q

What is the most common classification system used for ischaemic strokes?

A

Bamford classification (Oxford classification)

28
Q

How does the Bamford classification categorise strokes?

A

Based on the initial presentation and signs

29
Q

Does the Bamford classification require imaging?

A

No - it is purely clinical

30
Q

What are the types of strokes in the Bamford classification?

A
  • TACS
  • PACS
  • POCS
  • LACS
31
Q

What does TACS mean?

A

Total Anterior Circulation Stroke

32
Q

What is a TACS?

A

A large cortical stroke affecting areas supplied by the ACA and MCA

33
Q

What is the criteria for a TACS?

A

All three of:

  • Unilateral weakness (or sensory deficit) of the face, arm and leg
  • Homonymous hemianopia
  • Higher cerebral dysfunction
34
Q

What are some examples of higher cerebral dysfunction seen in TACS?

A
  • Dysphasia

- Visuospatial disorder

35
Q

What does PACS mean?

A

Partial Anterior Circulation Stroke

36
Q

What is a PACS?

A

A less severe form of TACS where only part of the anterior circulation (ACA and/or MCA)

37
Q

What is the criteria for a PACS?

A

Two of:

  • Unilateral weakness (or sensory deficit) of the face, arm and leg
  • Homonymous hemianopia
  • Higher cerebral dysfunction
38
Q

What does POCS mean?

A

POsterior Circulation Syndrome

39
Q

What is a POCS?

A

Stroke involving damage to the area of the brain supplied by the posterior circulation (e.g. brainstem and cerebellum)

40
Q

What is the criteria for a POCS?

A

One of:

  • Cranial nerve palsy and a contralateral motor/sensory deficit
  • Bilateral motor/sensory deficit
  • Conjugate eye movement disorder
  • Cerebellar dysfunction
  • Isolate homonymous hemianopia
41
Q

What is an example of a conjugate eye movement disorder that may be seen in a POCS?

A

Horizontal gaze palsy

42
Q

What are some examples of cerebellar dysfunction that may present in a POCS?

A
  • Vertigo
  • Nystagmus
  • Ataxia
43
Q

What does LACS mean?

A

LACunar Syndrome

44
Q

What is a LACS?

A

A subcortical stroke occurring secondary to small vessel disease

45
Q

What does NOT occur in LACS?

A

Loss of higher cerebral function (e.g. dysphasia)

46
Q

What are the criteria for LACS?

A

One of:

  • Pure sensory stroke
  • Pure motor stroke
  • Sensori-motor stroke
  • Ataxis hemiparesis

ANKI Neuro (30 decks)

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