Acute stroke (8.5)

Question 1

Define the following:

• Stroke
• Transinet Ischaemic Attack
• Amaurosis Fugax

Answer 1

Stroke: Rapidly developing clinical signs of focal disturbancce of cerebral function, lasting more than 24 hours or leading to death, with the cause of vascular origin

TIA: Symptoms lasting < 24 hours. Most resolve within 1 hour.

• A small percentage are due to primary haemorrhage

Amaurosis fugax: Retinal TIA. Presents with transient monocular blindness which is painless

Question 2

Describe the risk factors, clinical presenting features, pathological causes and consequences of ischaemic and haemorrhagic stroke

Question 3

List the clinical differences between a stroke which arises from the anterior and posterior circulation

Answer 3

Anterior circulation: Loss of awareness of one side of the body (hemi-neglect), if the lesion occurs on the non-dominant side (usually the right)

Question 4

Explain the OSCP classification of stroke and describe the prognostic difference between each stoke type

Answer 4

Question 5

Describe the acute management of stroke and TIA:

• Examination
• Investigations
• Antiplatelet therapy, anticoagulation, BP control

Answer 5

Question 6

Outline possible ‘sudden’ intracranial events

Answer 6

Question 7

List some non-specific symptoms associated with strokes

Answer 7

Headache

Confusion

Drowsiness or loss of consciousness

Dizziness

Nausea, vomiting

Double vision

Difficulty in swallowing, ‘dysphagia’

Weakness is motor muscles. Poorly co-ordinated swallow

Incontinence