Cerebral infarction

Question 1

Structural abnormalities

Answer 1

atherosclerosis of arteries going to or within the brain
Dilated atria (with AF) allow blood clots to form

Question 2

Physiological abnormalities

Answer 2

Ischaemia of brain tissue
Necrosis of brain tissue
Raised intracranial pressure due to oedema

Question 3

Possible warning

Answer 3

TIAs - Transient ischaemic attack - mini stroke

Question 4

Symptoms

Answer 4

Weakness of the arm/leg- usually on one side of the body
slurring of speech (dysarthria)
Drooping of the corner of the mouth
possible hypertension
Expressive dysphasia- can’t find the words or understand others

Question 5

Signs

Answer 5

possible AF
Possible hypertension
Possible Bruit- noise of turbulent blood flow - heard over a carotid artery in the neck

Question 6

Abnormal test results

Answer 6

Brain CT or MRI shows changes of brain ischaemia (reduced blood flow), swelling and infarction
Ultrasound carotid artery- narrowing
Echocardiogram- blood clot in the atrial appendage
ECG- may show AF

Question 7

Medical/surgical intervention

Answer 7

Thrombolytic drugs- dissolve clot and restore blood flow

Question 8

Primary and secondary prevention

Answer 8

Treat patients with AF with warfarin
Treat patients with carotid atherosclerosis with antiplatelt drug e.g. aspirin
Management hypertension