Geriatrics - Strokes and TIAs Flashcards
What is a stroke?
Sudden onset of focal neurological deficit lasting over 24 hours
When looking at imaging how are strokes classified?
Whether there is an infarct or haemorrhage
What classification is used to identify what vascular territory is involved in a stroke?
Bamford
What classification is used for underlying aetiology of infarcts?
TOAST
What are the different types of strokes?
Total anterior circulation stroke (TACS)
Partial anterior circulation stroke (PACS)
Lacunar stroke (LAC)
Posterior circulation stroke (POCS)
What type of stroke has the worst prognosis?
TACS
What assessment tools are used for assessing a patient with a suspected stroke?
FAST
Face
Arm
Speech
Time
ROSIER
Used to determine between a stroke and a stroke mimic
What is used to evaluate and document neurological status in acute stroke patients?
NIH stroke scale
(NIHSS)
What is used for thrombolysis?
Alteplase
What should all patients presenting with acute stroke with haemorrhage excluded be given?
Aspirin 300mg orally
or
Aspirin 300mg rectally
Continue for 2 weeks
How long are patients unable to drive after a stroke or TIA?
1 month
If recurrent TIAs cannot drive for 3 months and must be assessed prior to resuming
What classification is used to assess carotid stenosis?
North American Symptomatic Carotid Endarterectomy Trial
NASCET
- Referred within 1 week of onset of stroke for TIA or stroke
- Surgery in 2 weeks of onset
When should patients with severe MCA infarction be considered for decompressive hemicraniectomy?
- Any deterioration in clinical condition
- Under 60
- CT infarct of at least 50% MCA territory
- NIHSS over 15
