Control CS3 stroke and TIAs Flashcards

1
Q

What is a stroke?

A

An abrupt interruption of blood flow to part of the brain depriving the brain tissue of oxygen and nutrients leading to brain cell death

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2
Q

When is a stroke excluded as a diagnosis?

A

If subarachnoid haemorrhage
Trauma

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3
Q

What are three causes of ischaemia stroke?

A

Embolism
Thrombosis
Hypoperfusion

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4
Q

What can cause Hypoperfusion?

A

Low systemic perfusion pressure
Cardiac pump failure
Systemic hypotension
Asymmetric effects in pre existing vascular lesions causing an uneven distribution of underperfusion

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5
Q

What can increase risk of thrombosis?

A

Haematological diseases
Any systemic hypercoagulable state e.g. cancer
Arteritis

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6
Q

What are causes of a non-traumatic intracerebral haemorrhage?

A

Hypertension
Vascular malformations e.g. aneurysm
Amyloid angiography
Tumours
Drug abuse e.g. cocaine
Anticoagulants and thrombolytic therapy
Vasculitis
CVT

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7
Q

What test should be done if a stroke is suspected?

A

FAST test

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8
Q

What are common stroke symptoms?

A

Slurred/mumbled speech
Facial droop
Acute unilateral loss of strength +/- sensation
Acute vision loss - complete/incomplete, monocular/binocular
Aphasia
Ataxia +/- vertigo
Double vision
Sudden decrease in level of consciousness

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9
Q

What is the first investigation done when a patient presents with a suspected stroke?

A

CT scan

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10
Q

What is the treatment/management for a intracerebral haemorrhage?

A

Reverse anticoagulation
Aggressive blood pressure management
Surgical options in some cases e.g. stroke caused by aneurysm or complications like hydrocephalus

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11
Q

What is the name for the area that is at risk of damage after a stroke but it salvageable if perfusion occurs?

A

The penumbra

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12
Q

What is the process called where the penumbra is saved from infarct?

A

Recanalisation

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13
Q

What is a medication used for stroke?

A

Alteplase

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14
Q

How are large vessel occlusion strokes treated?

A

With mechanical thrombectomy (MT)

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15
Q

What is the difference between a TIA and a stroke?

A

A TIA is when a neurological deficit, as a result of cerebral or retinal ischaemia, lasts for less than 24 hours

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16
Q

How long do most TIAs last for?

A

Less than 60 mins

17
Q

Can TIAs cause brain damage?

A

Yes

18
Q

What are common causes of a TIA?

A

carotid artery/large artery disease
Cerebral small vessel disease
Cardiac embolism

19
Q

What percentage of strokes are preceded by a TIA?

A

20%

20
Q

Can a TIA be caused by a haemorrhage?

A

No

21
Q

What diseases/events can have symptoms that mimic a TIA/stroke?

A

Seizures
Syncope
Hypoglycaemia
Migraine
Acute confusion all states

22
Q

Which symptoms are specific to issues in the anterior arteries of the neck/brain?

A

Dysphasia
Amasausis fugax

23
Q

What symptoms are specific to issues in the posterior circulation of the brain/neck?

A

Ataxia
Diplopia
Vertigo
Bilateral symptoms

24
Q

What scoring system can be used when assessing the probability of a patient having a stroke after having a TIA?

A

ABCD2 score

A = age
B = BP
C = clinical features
D = duration of symptoms
D = diabetes