Cerebral Infarction - Ischarmic Stroke

Question 1

Anatomical structures affected in ischaemic stroke

Answer 1

All brain
Arteries to brain - carotid arteries, vertebral arteries
Small brain arteries

Question 2

What physiology goes wrong in an ischaemic stroke

Answer 2

• supply of oxygen and nutrients to brain
  = ischaemia of brain tissue
• necrosis - cell death in brain
• raised intracranial bores sure in skull due to brain swelling/odema = nerve cell damage
• CO2 and waste removal from brain

Question 3

Structural abnormalities leading to cerebral infarction/IS

Answer 3

• arterial wall disease eg: atherosclerosis
• dilated atria - with atrial fibrillation allows clot to form

Question 4

Risk factors/prior events to ischaemic stroke

Answer 4

• smoking, hypertension, dyslipidaemia, diabetes
• atrial fibrillation
• TIA

Question 5

Symptoms of IS

Answer 5

• face drooping, weakness of one side of face, sparing one side of the face
• weakness of one arm/leg
• slurred or incoherent speech

Question 6

Clinical signs of IS

Answer 6

• evidence of AF - irr irr pulse
• hypertension
• possible bruit (turbulent blood flow caused by atherosclerosis in carotid artery

Question 7

Abnrmal test results

Answer 7

• CT or MRI = changes of brain ischaemia, swelling, infarction
• Carotid artery narrowed on CA ultrasound
• ECHO cardiogram of heart shows blood clot in atrial appendage
• ELECTRO Cardiogram shows egidence of AF - eg irregular heart best with absent P waves

Question 8

Intervention in the case of Ischaemic stroke

Answer 8

Thrombolytic drugs to dissolve blood clots in the arteries, restoring blood glow within 4.5 hours of symptom onset

Question 9

Prevention of ISchaemic stroke

Answer 9

• Direct oral Anticoagulant (DOAC) or warfarin if atrial fibrillation present
• lowering of HIGH blood pressure