Ageing Flashcards
What is a stroke?
Rapidly developing clinical symptoms and signs of focal and/or global loss of brain function with symptoms lasting more than 24 hours or leading to death with no cause other than vascular
What are important questions to think about when assessing stroke?
Time of onset?
What were/are the symptoms?
How did they progress?
What are some stroke mimics?
Seizure Sepsis Toxic/metabolic Space occupying lesions (Pre)syncope Acute confusion/delerium Vestibular dysfunction Functional Dementia
What are the factors of the rosier score?
LOC (-1) Seizure (-1) Acute onset of: -Asymmetric facial weakness -Asymmetric arm weakness -Asymmetric leg weakness -Speech disturbance -Visual field defect (>0 stroke is likely)
What are the 3 main types of stoke?
Haemorrhage
Subarachnoid haemorrhage
Infarct
What are the causes of haemorhage stroke?
Structural abnormality
Hypertensive
Amyloid angiopathy
What are the causes of infarct stroke?
Atheroembolic
Small vessel
Cardioembolic - AF
How can infarct and haemorrhage be differentiated?
Head CT
- Acute blood in the brain shows up white
- Infarct shows oedema and fluid which shows up as slightly darker and ‘fuzzy’
What side of the body will be affected in a right sided bleed?
Left side of the body
How is a stroke managed?
Acute: Thrombolysis/Thrombectomy Imaging Swallow assessment Nutrition and hydration Antiplatelets Stroke unit care DVT prevention
What factors can affect the decision to thrombolise?
Age Time since onset Previous stroke Atrophic changes Blood pressure Diabetes Potential benefit Premorbid state
How can stroke symptoms be recognised in the community?
FAST Facial Arm Speech Time(?)
What must be done before thrombolysis?
CT scan
What should be given ASAP to reduce risk of further infarct?
Antiplatelets (Aspirin)
Not until 24hrs if thrombolysed
What prophylaxis can be given for DVT?
Intermittent pneumatic compression
