Ischaemic Events Flashcards
What is a transient ischaemic attack (TIA)?
Sudden onset, focal neurological deficit lasting, < 24hrs with complete clinical recovery
What are the causes of TIA? (3)
- Atherothromboembolism from carotids
- Cardioembolism
- Hyperviscosity eg polycythaemia
What is amaurosis fugax?
Emboli passes into retinal artery –> “curtain descending over my field of vision” [EMERGENCY]
How would you investigate TIA? (3)
- ABCD2 score
- High risk: admit; carotid doppler, CT angiography w contrast
- Low risk: refer for specialist assessment w/in 7 days of symptom onset
How would you treat TIA? (4)
- Control CV risk factors (optimise BP, DM, stop smoking)
- Aspirin 300mg OD 2 weeks (then clopidogrel 75mg)
- Statin = simvastatin 40mg
- Treat BP = bisoprolol
Can patient’s drive after having a TIA?
No. Driving is prohibited for at least a month.
No driving until seen by a specialist.
What is a stroke?
Rapidly developing signs of focal + global disturbances of cerebral functions lasting > 24hrs or leading to death
What are the main 3 clinical presentations of stroke?
- Facial weakness/ droop
- Arm/ leg weakness
- Speech problems
What is the clinical presentation of an ACA stroke? (4)
- Drowsiness
- Impaired logical thinking
- Incontinence
- Personality change
What is the clinical presentation of an MCA stroke? (4)
- Motor weakness. hemiplegia
- Sensory disturbances
- Aphasia
- Dysphagia
What is the clinical presentation of a PCA stroke? (2)
- Contralateral homonymous hemianopia
- Prosopagnosia
How would you investigate stroke?
CT scan
How would you treat ischaemic stroke? (2)
- Thrombolysis - IV alteplase
- Aspirin 2 wks, then clopidogrel
How would you treat haemorrhagic stroke? (3)
- Control BP = beta-blocker/ ARB
- Beriplex if warfarin related
- Surgery (decompression/ craniotomy)
How would you treat a stroke pt post-emergency treatment? (2)
- Rehabilitation = physio, OT
- Modify risk factors = stop smoking, exercise
