Acute Stroke On Hyperacute Stroke Unit

Question 1

Definition of stroke

Answer 1

Rapidly developing symptoms

Clinical signs of of focal disturbance of cerebral function

Symptoms lasting longer 24 hours

No apparent cause other than vascular origin

Question 2

Large stroke (ischaemic)

Answer 2

Occlusion or stenosis >50% ) in large extracranial or intercranial cerebral arteries , with ischaemia in that arterial territory

Question 3

Cardioembolic stroke

Answer 3

One or more of following

Mechanical prosthetic heart valve 
AF
MI  in last 2 months
Dilated cardiomyopathy 
Congestive heart failure at stroke onset
Endocarditis 
Sick sinus syndrome 
Atrial myxoma 
Left ventricular thrombus

Question 4

Lacunar stroke

Answer 4

Lacunar stroke with either no lesion on brain imaging on an infarct

Question 5

How to treat acute ischaemic stroke

Answer 5

IV. Thrombolysis
Endovascular interventions

Antiplatelet therapy

Decompressibe strategy

Stroke care unit

Question 6

Thrombectomy time window.?

Answer 6

Under 6-8 hours

Question 7

When to stage a thrombectomy

Answer 7

If large artery occlusion not responded to IV thrombolysis

Question 8

Details of antiplatelet therapy

Answer 8

Aspirin 300mh in acutesyroke

Reduction in early recurrent stroke

Question 9

Transient ischaemic attack features

Answer 9

Sudden onset
Focal neurological deficit

Presumed vascular origin

Lasting longer than 24hrs

Most TIA resolve in under 1 hour

Many TIA have evidence of infarction o brain imaging