8. Stroke and TIA

Question 1

How many neurons are lost every minute a stroke goes untreated?

Answer 1

1.9 million

Question 2

What percentage of strokes are ischaemic and haemorrhagic?

Answer 2

80% ischaemic

20% haemorrhagic

Question 3

How is a TIA diagnosed?

Answer 3

History key as event was transient

Question 4

What is amaurosis fugax?

Answer 4

Painless transient loss of vision in 1 eye

Question 5

What are the symptoms of TIA if the carotid artery territory is involved?

Answer 5

Amaurosis fugax
Contralateral weakness/numbness
Dysphagia

Question 6

What are the symptoms of TIA if the vertibrobasilar territory is involved?

Answer 6

Ataxia, vertigo
Dysarthia
Diplopia, hemianopia, bilateral visual loss

Question 7

What is the average duration of a TIA?

Answer 7

5-15 mins

Question 8

What is calculated by the ABCD2 score?

Answer 8

Likelihood a patient with TIA will develop a stroke

Question 9

What are the features of the ABCD2 score?

Answer 9

Age
BP
Clinical
Duration
Diabetes

Question 10

How is TIA investigated?

Answer 10

Pulse and ECG for a.fib
Neuro exam
Urgent carotid doppler

Question 11

What is the management for a patient with TIA?

Answer 11

No driving for 30 days

ABCD2>4 = endarterectomy within 2 weeks

Question 12

How is stroke prevented after a TIA?

Answer 12

Antithrombic and anticoagulant meds
BP control, statin
Stop smoking, exercise, screen for diabetes

Question 13

What is the treatment for stroke?

Answer 13

Intra-arterial thrombolysis

Thrombectomy

Question 14

What are the parts of the ABCD2 score that receive one point?

Answer 14

Age >60
BP > 140/80
Speech problem without weakness
10-60 mins
Diabetes

Question 15

What parts of the ABCD2 score receive 2 points?

Answer 15

Hemiparesis

Duration >1 hour