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Neurology System > Cerebral Infarction > Flashcards

Cerebral Infarction Flashcards

1
Q

What is a big prognostic factor in stroke?

A

Ageing

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2
Q

What is a stroke?

A

Sudden onset of focal or global neurological symptoms caused by ischaemia or haemorrhage and lasting >24 hours

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3
Q

What % of strokes are ischaemic

A

85%

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4
Q

What % of strokes are hemorrhagic?

A

15%

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5
Q

What is a TIA?

A

Mini stroke

Symptoms resolve within 24 hours

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6
Q

What does stroke risk increase with?

A

Age

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7
Q

What is the FAST approach?

A

Facial weakness
Arm weakness
Speech
Time - call 999

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8
Q

Why are MRI’s not often used as imaging even though they are better for imaging strokes?

A

Because they take time

And are impractical for such an acute situation

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9
Q

How does blood show on CT?

A

White

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10
Q

Why is CT good for imaging stroke?

A

Blood shows up white

Good for distinguishing ischaemic and haemorrhagic

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11
Q

What causes ischaemic stroke?

A

Failure of cerebral blood flow to a part of the brain

Interruption of the blood supply to the brain

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12
Q

What is anoxia?

A

No oxgen

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13
Q

What are the non-modifiable risk factors for stroke?

A

Previous stroke
Being old
Male
Bad FH

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14
Q

What is the most important modifiable risk factor for stroke?

A

Hypertension

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15
Q

What are the modifiable risk factors for stroke?

A 
Hypertension 
High lipid levels 
Alcohol and obesity 
Smoking
DM
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16
Q

What is necrosis?

A

Cell death

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17
Q

What effect does chronic hypertension have of the brain?

A

Worsens atheroma

Affect small distal arteries

18
Q

By what fold does DM increase the incidence of stroke?

A

By 3 fold

19
Q

By what fold does smoking increase the incidence of cerebral infarction?

A

2 fold

20
Q

By what fold does smoking increase the incidence of sub-arachnoid haemorrhage?

A

3 fold

21
Q

Which factors contribute to LDL-C deposition in the arterial walls?

A

Hypertension
Smoking
DM

22
Q

How do small amounts of alcohol affect your stroke risk?

A

Decreases it

23
Q

How does heavy drinking affect you stroke risk?

A

Increases it

24
Q

Which OCP increases stroke risk?

A

Oestrogen content ones only

25
Q

Describe the anterior circulation of the brain

A

2x ICA
2x anterior cerebral artery
2x middle cerebral artery

26
Q

Describe the posterior circulation of the brain

A

2x vertebral arteries
3 pairs of cerebellar arteries
2x posterior cerebral arteries

27
Q

How is the anterior circulation of the brain connected to the posterior circulation of the brain?

A

By the circle of willis

28
Q

What are the symptoms of ACA occlusion?

A

Contralateral paralysis of foot and leg
Sensory loss over foot and leg
Impairment of gait and stance

29
Q

What are the symptoms of MCA occlusion?

A 
Contra-lateral 
paralysis of face/arm/leg
sensory loss face/arm/leg
homonymous hemianopia
Gaze paralysis to the opposite side
Aphasia stroke - if on dominant side 
Unilateral neglect and agnosia for half of external space - non-dominant side
30
Q

Which type of stroke has the worst prognosis?

A

TACS

31
Q

What is TPA?

A

Tissue plasminogen activator

32
Q

What is the function of TPA?

A

Anticoagulant

Breaks down blood clots

33
Q

What is the cut off time of use of TPA?

A

<4.5 hours

34
Q

What is included in the exclusion criteria for IV TPA?

A

Anything that increases probability of haemorrhage
i.e blood on CT, recent surgery, recent bleeding episode, coagulation problems
BP >185 systolic or >110 diastolic
Glucose <2.8 or >22 mmol/L

35
Q

Who are some of the member of the disciplinary team involved in dealing with stroke patients?

A 
Clinical staff 
Stroke nurse
Physio 
Speech and language therapist
Occupational therapists
Dietician 
Psychologists 
Orthoptist
36
Q

What is the treatment for stoke?

A

IV TPA
Aspirin
Thrombectomy

37
Q

What is TIA a warning sign of?

A

Stroke

38
Q

What blood test investigations are carried out for stroke?

A

FBC
Glucose
Lipids
ESR

39
Q

What other investigations are carried out for stroke?

A 
CT 
MRI 
ECG 
Echo 
Carotid doppler 
Cerebral angiogram 
Hyper-coagulable blood screen
40
Q

What treatments can be given as secondary prevention?

A 
Anti-hypertensives
Anti-platelets 
Lipid lowering drugs 
Warfarin for AF 
Carotid endarectomy

Neurology System (35 decks)

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