Clinical aspects of stroke Flashcards
What does middle cerebral artery supply?
supplies lateral hemisphere convexity and underlying cortex and wm
what does porterior cerebral artery supply?
medial temporal occipital parietal lobe
what do motor areas give rise to?
fibres that come down to coronradiata wmand converge interlal capsule
what affect can an infarct have on the motor system and why/
infarct can cause extensive motor deficit (face,arm leg) because fibres are closely packed in the subcortical region
what are clinical signs of ischaemic stroke due to total mca territory infraction
hemiparesis
drowsy
hemisensory loss
cortical signs - visual field loss, inattention, neglect
what clinical signs do you see on small deep lacunar infarct (ischaemic stroke)
hemiparesis
normal conscious level and no cortical signs
what clinical signs do you see on lower brainstem infarct (ischaemic stroke)
right tongue weakness
mild left hemiparesis
left sided sensory loss
no cortical signs
what % is ischameic/haemorrhage
80% - ischaemic - loss of blood flow/blockage
20* haemorrhage - bleeding within brain –> 15% primary intracerebral, 5% subarachnoid
What are mechanisms due to risk factors such as hypertension, alchohol, obesity etc. ?
small vessel occlusion or rupture
large artery-artery embolism
cardiac embolism
haemodynamic
main causes of ischaemic stroke - embolism (clot goes from one place to another)
thrombus, atheramatous material, vegetations
from the heart (atrial fibrillation, valvular heart disease, myocardial infarction)
from the extracranial carotid or vertebrobasilar vessels (atheroma, dissection)
main causes of ischaemic stroke - in situ thrombosis
small perforating vessel occlusion (lacunar)
large vessel occlusion
venous occlusion
what are rare causes of ischaemic stroke
dissection vasculitis and SLE drug migraine meningitis endocarditis atrial myxoma antiphospholipid syndrome Fabry's disease moya-moya
what is seen on interal carotid artery dissection
rapid narrowing of lumen
crescent of blood in the vessel wall
small emboli in the carotid territory
what are symptoms of acute intracerebral haemorrhage and what do you see on CT
bright on CT
drowsiness
headache
hypertension
what are rare causes of intracranial haemorrhage
cerebral vasculitis
cerebral venous thrombosis
drug abuse
cerbral tumours