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Neurology > Cerebrovascular Disease > Flashcards

Cerebrovascular Disease Flashcards

1
Q

What is a stroke?

A

A rapidly developed condition of focal/global loss of brain function.

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2
Q

What is the most common cause of a stroke?

A

Infarction

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3
Q

Asides from infarction, what are other causes of stroke?

A

Subarachnoid haemorrhage

Intracerebral haemorrhage

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4
Q

What are the potential causes of a cerebral haemorrhage?

A

Hypertension
Amyloid angiopathy
Structural abnormality

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5
Q

What is the first-line imaging in those suspected to have suffered a stroke?

A

CT brain

Can take time to appear in infarction (hyperacute scan will be normal).

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6
Q

What form of imaging is second-line to CT scan in stroke?

A

MRI scan

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7
Q

What is the aim of stroke treatment?

A

Reperfuse the affected tissue.

Time = Tissue.

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8
Q

What 3 signs should be tested for in a suspected stroke?

A

Facial weakness
Arm weakness
Speech problems

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9
Q

What is the main method of treatment in stroke?

A

Thrombolysis

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10
Q

When is thrombolysis contraindicated?

A

Intracerebral haemorrhage
Atrophy
High BP
Diabetes

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11
Q

Why should CT always be performed prior to thrombolysis therapy in suspected stroke?

A

To ensure causation is a clot and not a haemorrhage.

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12
Q

What is endovascular therapy?

A

The physical removal of a clot. Does not involve any drug treatment.

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13
Q

Should antiplatelets be given in stroke?

A

Yes

If thrombolysed, wait 24 hrs and CT scan for any damage prior to initiation.

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14
Q

How should a mild stroke be managed long-term?

A

Aspirin and clopidogrel - 3 weeks.

Give a single antiplatelet therapy thereafter.

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15
Q

What is used to prevent DVT in those immobilised by a stroke?

A

Intermittent pneumatic compression.

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16
Q

What are TIAs?

A

Transient episodes of temporary arterial occlusion.

Lasts less than 24 hours.

17
Q

What is the difference between a stroke and a TIA?

A

Stroke lasts > 24 hours.

TIA lasts < 24 hours.

18
Q

When is a diagnosis of TIA made?

A

Following the cessation of symptoms.

19
Q

Why is it important to manage a TIA effectively?

A

It can lead to a stroke within a few days.

20
Q

How is a TIA investigated?

A

Carotid imaging
ECG
Blood tests

21
Q

How is a TIA managed?

A

Antiplatelet therapy

Statin therapy

22
Q

Should hypertension be treated in those with an infarct stroke?

A

No, as this may be the factor allowing the brain to be perfused.

23
Q

Should hypertension be treated when giving thrombolysis?

A

Yes, as this may result in haemorrhage.

24
Q

If systolic >150mmHg in case of primary intracerebral haemorrhage, what should be given?

A

Antihypertensives for atleast 7 days.

IV GTN can be used for rapid relief.

25
Q

What is used to reverse the effects of warfarin?

A

Vitamin K

26
Q

Where does an intracerebral haemorrhage occur?

A

Within the brain parenchyma.

27
Q

What is the most common cause of intracerebral haemorrhage?

A

Trauma.

28
Q

What is amyloid angiopathy?

A

The deposition of amyloid in the blood vessel walls, weakening them.

This disrupts the blood brain barrier.

29
Q

Where are intracerebral haemorrhages linked to hypertension typically seen?

A

Basal ganglia

30
Q

What are focal symptoms seen in ICH?

A 
Paresis
Dysphagia/Aphagia
Numbness
Seizure
Visual symptoms
31
Q

What are global symptoms seen in ICH?

A

Headache
Nausea + Vomiting
Reduced GCS
Pupils

32
Q

How is ICH treated?

A

Surgery

33
Q

What are the 3 categories of the GCS?

A

Eye response
Verbal response
Motor response

34
Q

How is ICH diagnosed?

A

Digital subtraction angiography is gold standard.

35
Q

What do Hounslow’s units differentiate between?

A

Calcium deposits and blood.

36
Q

Where is the most common area for a cerebral artery aneursym?

A

Anterior communicating artery

37
Q

What is the appearance of a cavernoma?

A

Has a characteristic ‘pop-corn’ appearance.

38
Q

What does haemosiderin presence indicate?

A

Multiple cavernoma

Neurology (22 decks)

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