Carotid Dis Flashcards
1
Q
Stroke vs TIA
A
Stroke- acute loss cerebral func, symps over 24hr or leading to death. No cause other than vascular.
TIA- same but under 24hr.
2
Q
causes
A
Isch 80%-
Carotid isch 60%- TE, small vess dis, cardiac embol, haematologic, misc.
vertebrobasilar 20%
Haemorrhage 20%
3
Q
non hemis symps are NOT carotid dis
A
Isolated diplopia Isol vertigo Isol dizziness Presyncope Syncope
4
Q
mx if caroitd territory symps
Eg sensory, motor, blindness, higher cortical, dysarhtria, ataxia, hemianopea.
A
BP mx Statin Angina mx Asp, dipyridamole, clopidogrel Stop smoking and drink Exercise, diet Gluc control Carotid endarterectomy if mod or sev dis, but not if total occlus CEA for asymp carotid dis if fit, under 70 or 75, life expec over 5yr, accepts risk of stroke and CN inj. Angioplasty has worse outcomes than CEA
5
Q
ix
A
FBC Biochem screen ECG CXR CT, MRI to exclude haemorrhage US
6
Q
Stroke acute mx
A
Alteplase if isch, within 4.5
Asp within 24hr, but after tlysis. Plus PPI. Or clopidogrel if not asp. This is for isch only.
Haemorr may req surg to remove haematoma and relieve press.
7
Q
stroke LT mx
A
Lifestyle- ex, wl, smok, alc. LT clopidogrel and asp. Or dipridamole if not. This is for isch. Not if haemorr. Reciew need for warfarin ONYL if AF Statin if isch stroke, not if haemorr. AntiHTN if reqm pref not BB.
