Diagnosis and Epidemiology

Question 1

What is a stroke?

Answer 1

Acute onset of focal neurological symptoms/signs due to interruption of blood supply

Question 2

What differentiates a TIA from a stroke?

Answer 2

Any residual symptoms even if improved means stroke
TIA is short term (true TIA is <1hr), old definition is <24 hrs

Question 3

What is an ischemic stroke?

Answer 3

Blood clot stops flow of blood to brain

Question 4

What proportion of strokes are ischemic?

Answer 4

85%

Question 5

What is a hemorrhagic stroke?

Answer 5

Blood vessel rupture

Question 6

What are some risk factors for stroke?

Answer 6

• Hypertension
• Particulate matter pollution
• Obesity
• Diabetes
• Smoking
• High Na diet
• High cholesterol
• Atrial Fibrillation

Question 7

What is the biggest risk factor for stroke?

Answer 7

Hypertension

Question 8

What are features of an anterior stroke effecting the anterior/middle cerebral arteries?

Answer 8

• Hemiparesis
• Hemisensory loss
• Hemianopia
• Dysphasia (left MCA)
• Sensory/visual inattention/ neglect (right MCA)

Question 9

What arteries can be effected in an anterior stroke?

Answer 9

• Anterior/middle cerebral artery
• Perforating arteries

Question 10

What are dome features of a stroke effecting the perforating arteries?

Answer 10

• Pure motor stroke
• Pure sensory stroke
• Sensorimotor stroke
• Clumsy hand dysarthria
• Ataxic hemiparesis

Question 11

What is another term to describe symptoms of a stroke effecting the perforating arteries?

Answer 11

Lacunar symptoms

Question 12

What symptoms can be expected in a stroke effecting the occipital cortex?

Answer 12

Hemianopia

Question 13

Name some symptoms of a stroke effecting brainstem & cerebellum?

Answer 13

• Hemiparesis/hemisensory loss
• Ataxia
• Dysarthria
• Vertigo, diplopia, facial nerve palsy, tongue palsy, dysphagia

Question 14

Can a posterior stroke present with bilateral symptoms?

Answer 14

Yes - in basilar artery syndrome

Question 15

What are the different oxford classifications of stroke?

Answer 15

• TACS
• PACS
• LACS
• POCS

Question 16

What is the worst oxford classification of stroke?

Answer 16

TACS

Question 17

How does TACS present?

Answer 17

• Hemiplegia effecting at least two of face, arm & leg +/- hemisensory loss
• Homonymous hemianopia
• Cortical signs

Question 18

What does TACS stand for?

Answer 18

Total anterior circulation syndrome

Question 19

What does PACS stand for?

Answer 19

Partial anterior circulation syndrome

Question 20

How does PACS present?

Answer 20

• Hemiplegia effecting at least two of face, arm & leg +/- hemisensory loss
• Cortical signs
  OR
• Isolated cortical dysfunction
  OR
• Monoparesis

Question 21

What does LACS stand for?

Answer 21

Lacunar syndrome

Question 22

How does LACS present?

Answer 22

Motor or sensory or both affecting 2 of face, arm and leg

Question 23

What does POCS stand for?

Answer 23

Posterior circulation syndrome

Question 24

How does POCS present?

Answer 24

• Cranial nerve palsy
• Conjugated eye movement disorder
• Isolated homonymous hemianopia
• Cortical blindness
• Cerebellar deficits +/- motor/sensory signs
• Bilateral signs

Question 25

What is the most common classification of stroke?

Answer 25

POCS

Question 26

What is a chameleon in terms of stroke?

Answer 26

False-negative

Question 27

What classification of stroke has the best prognosis?

Answer 27

LACS

Question 28

What is a stroke mimmic?

Answer 28

A false-positive

Question 29

What is the most common stroke mimmic?

Answer 29

Seizure