7: Stroke Flashcards
What is stroke?
Acute onset of neurological symptoms/signs due to disruption of blood supply (ischaemia)
Stroke tends to cause ___ rather than death.
disability
The majority of stroke is (haemorrhagic / ischaemic).
ischaemic
What is a large risk factor in both haemorrhagic and ischaemic stroke?
Hypertension
Why may you develop a haemorrhagic stroke?
Poor blood coagulation due to drugs (e.g warfarin, NOACs, anti-platelets)
Structural abnormalities (e.g aneurysm, AVM)
Inflammation (vasculitis)
Name three kinds of ischaemic stroke.
Thrombotic (blockage originates in brain)
Embolic (thrombus travels distally and blocks vessel in brain)
Hypoperfusion (BP < 60mmHg, not enough to perfuse brain adequately)
What are some non-modifiable risk factors of stroke?
Age
Family history of stroke
Gender
Race
Previous history of stroke
What are some modifiable risk factors for stroke?
Hypertension
Hyperlipidaemia
Smoking
Diabetes
(Also: AF, congestive heart failure, alcohol, obesity, exercise, ?deprivation)
An important step in diagnosing stroke is ruling out diseases which __ its symptoms.
mimic
What are some common stroke mimics?
Hypoglycaemia
Seizures (e.g epilepsy)
Migraines
Brain tumours
Paralysis
What are some important questions to ask about stroke in history?
Time of onset?
Was anyone with you?
Standard Calgary-Cambridge
What is the only reliable way of differentiating between ischaemic and haemorrhagic stroke?
Brain imaging
e.g CT, MRI scan
The large dark area of brain on Slide 21 is ___.
infarcted tissue.
The large white spot on Slide 22 is ___ - a sign of ___ stroke.
blood , haemorrhagic
If you find infarcts in more than one artery, the clot has likely come from the __.
heart.
If you see infarcts on only one side, the clot has likely come from…
the vessel itself.
In older patients, the cause of bleed associated with haemorrhagic stroke is likely…
hypertension.
If a young person has a haemorrhagic stroke, you should investigate for underyling…
aneurysm, AVM.
What does TIA stand for?
Transient ischaemic attack
What is a transient ischaemic attack?
Focal neurological symptoms which resolve themselves within a few minutes –> 24 hrs
A TIA (is / isn’t) a medical emergency.
is
Around 10% of people who have a TIA then go on to have a disabling ___.
stroke
What is thrombolysis?
The process of opening a blocked vessel using drugs / mechanical means
Patients who have presented very soon after the stroke has started are treated with ___ drugs.
thrombolytic
Which drugs are used to manage stroke?
Anti-platelets (aspirin, clopidogrel)
Statins
Anticoagulations if in AF
What surgical treatment for stroke literally involves sucking the thrombus out of the vessel?
Haematoma evacuation
Parts of the skull may be temporarily removed following stroke to relieve increased ___ pressure.
intracranial pressure
