28. Acute Stroke

Question 1

Stroke Definition

Answer 1

Stroke is a cerebrovascular disorder resulting from impairment of cerebral blood supply by occlusion (eg, by thrombi or emboli) or hemorrhage characterized by acute-onset signs and symptoms of focal neurologic deficits lasting for >24 hours* or leading to death, with no apparent cause other than that of vascular origin (WHO)
• Transient Ischemic Attack (TIA) on the other hand, is the sudden-onset FND lasting for less than 24 hours, this is not included in the definition of stroke, although they have a common cause

Question 2

Diagnosis

Give the 5

Answer 2

Cranial CT Scan
o Differentiates between hemorrhage from ischemic stroke
o Demonstrates size and location of hemorrhage
o May reveal structural abnormalities (ie. brain tumors, AV malformations, herniations,
hydrocephalus) • Cranial MRI
o More sensitive than CT Scan for detecting cerebral infarction during the acute stage
• 4-Vessel Angiography: Intracerebral/subarachnoid hemorrhage secondary to aneurysm or AVM
• Cardiac Work Up: ECG, 2D Echo with Doppler, Cardiac duplex
• Blood chemistry – for the assessment of the above mentioned risk factors