Clinical Aspects of Stroke

Question 1

What is the definition of a stroke?

Answer 1

A sudden, focal neurological deficit due to a vascular lesion lasting longer than 24 hours

Question 2

What is the definition of a Transient Ischaemic Attack (TIA)?

Answer 2

A focal deficit lasting a few seconds to less than 24 hours. There is complete recovery

Question 3

With respect to the Central Sulcus, where is the Primary Motor cortex located?

Answer 3

Anterior to the Central sulcus

Question 4

With respect to the Central Sulcus, where is the Primary Somatosensory cortex located?

Answer 4

Posterior to the Central sulcus

Question 5

Where is Broca’s area and Wernicke’s area located in the brain?

Answer 5

FrOntal lobe = BrOca

PariEtal / TEmporal lobe = WErnickE

Question 6

Describe Broca’s aphasia and Wernicke’s aphasia

Answer 6

Broca’s: Expressive aphasia. Can understand but cannot produce speech

Wernicke’s: Receptive aphasia. Cannot understand but can produce speech

Question 7

What are the three types of Ischaemic stroke? Describe each of them

Answer 7

Thromboembolic stroke: Blot clot has developed in the brain

Embolic stroke: Blood clot has developed elsewhere and has travelled to the brain

Lacunar stroke: Small infarcts between 2 and 20mm

Question 8

Describe what Procopagnosia is?

Answer 8

Inability to recognise people’s faces

Question 9

What is the most common site of Occlusion in the Circle of Willis?

Answer 9

Middle cerebral artery

Question 10

In which chamber of the heart can a blood clot form which has a direct route to the brain?

Answer 10

Left atrium, i.e. in AF or MI due to stagnant blood

Question 11

In which chamber of the heart can a blood clot form which has a direct route to the lungs?

Answer 11

Right atrium

Question 12

In which condition might you get a paradoxical embolism where blood flows from the venous circulation to arterial circulation?

Answer 12

Patent Foramen Ovale

Question 13

What is a Watershed Infarct?

Answer 13

Ischaemia of the brain localised to the vulnerable border of zones between tissues supplied the cerebral arteries

Question 14

What is the ischaemic penumbra?

Answer 14

Zone around an ischaemic event

Question 15

What is the acute treatment for a Cerebral infarction?

Answer 15

• Tissue Plasminogen activator

- Aspirin and statins

Question 16

What are some risk factors for stroke?

Answer 16

Hypertension
Atrial Fibrillation
Smoking
Hypercholesterolaemia
Diabetes
Exercise
Diet

Question 17

What is the main cause for a Haemorrhagic stroke?

Answer 17

Hypertension

Question 18

Aside from hypertension, what are other causes of Haemorrhagic stroke?

Answer 18

• Arterio-venous malformations
• Vascular tumours
• Amyloid angiopathy

Question 19

What is the main treatment for Haemorrhagic stroke?

Answer 19

Antihypertensives