Extracranial cerebrovascular disease

Question 1

‘Fleeting blindness’

Answer 1

Amaurosis fugax

Question 2

Two types of strokes

Answer 2

Ischaemic (80%)

Haemorrhagic (20%)

Question 3

Two theories as to why atherosclerosis causes stroke

Answer 3

Embolic theory

Haemodynamic theory

Question 4

Stroke risk following TIA

Answer 4

ABCD2
Age >60
BP >140/90
Clinical features (focal weakness/ speach)
Duration >60mins
Diabetes

Question 5

Imaging carotids and brain

Answer 5

Duplex ultrasound

CT and MRI

Question 6

How do we know whether we can clamp carotid in CEA

Answer 6

Measure stump pressure. If > 50mmHg and pulsatile carotid vessels can be clamped as retrograde perfusion is adequate.

Question 7

Who gets carotid angioplasty and stenting

Answer 7

Symptomatic fibromuscular dysplasia

Those unfit for surgery

Question 8

CEA complications

Answer 8

· Ipsilateral Ischaemic Stroke form embolization during procedure
· Labile blood pressure and hypertension
· Acute Coronary Syndrome
· Death
· Local neck haemorrhage/haematoma
· Nerve injuries – vagus, recurrent laryngeal, hypoglossal,
glossopharyngeal