Ischaemic Stroke

Question 1

What are the risk factors for a ischaemic stroke?

Answer 1

Age

Hypertension

Smoking

Diabetes

AF

Obesity

Hypercholesteramie/lipidaemia

Question 2

What does a damaged brain due to ischamia look like on a CT?

Answer 2

Dark, as the tissue has died.

N.B It takes hours for this to show, so it may not be present straight away

Unlike haemorrhagic stroke there is no pain as there are no nerve endings in the brain

Question 3

What is a Total Anterior Circulation stroke?

Answer 3

Anterior and middle cerebral ateries are affected

Question 4

What is a Partial Anterior Circulation Stroke?

Answer 4

Middle cerebral arteries are affected

Question 5

What is a Posterior Circulation Stroke

Answer 5

The Posterior cerebral artery is affected

Question 6

What is a Lacunar stroke and what are the defining characteristics?

Answer 6

• Stroke deep in the brainstem affecting the small arteries
• It affects face, arms and legs and is either sensory or motor

Question 7

What would a stroke of the Anterior Cerebral arteries present with?

Answer 7

• Loss of function/sensation in the legs due to this area of the cortex being affected
• Apraxic gait
• Frontal reflex release - grasp and sucking reflex
• CONTRALATERAL to affected artery

Question 8

What would a stroke of the Middle Cerebral arteries present with?

Answer 8

• Hemiparesis (contralateral)
• Hemiplagia (contralateral)
• Dysphasia
• Contralateral homonymous hemianopia

Question 9

What would a stoke of the Posterior Cerebral Arteries present with?

Answer 9

Contralateral hemianopia +/- macular sparing

Contralateral facial nerve defects

Ipsalateral occulomotor nerve defects

Question 10

What is Bells Palsy?

Answer 10

LMN damage of the facial nerve causing drooping and no forehead sparing (UMN is forehead sparing)

Question 11

What would a stroke in the pontine arteries present like?

Answer 11

• Vertigo
• Difficulty breathing
• CN disruption
• Irregular heartbeat

Question 12

What would a stoke of the internal capsule present like?

Answer 12

Facial, arm and leg involvement

Either sensory or motor as this is where all the fibres come together when going to/from the cortex

Question 13

What would a TIA/stroke of the internal carotids cause?

Answer 13

• Brief hemiparesis contralateral
• Amaurosis fugax of ipsalateral side due to flow to the opthalmic arteries
• Dysarthria
• Dysphasia

Question 14

How would a stroke of the brainstem present?

Answer 14

• This can be very variable due to all of the CN that are here ( 4,4,2)
• They often present with contralateral hemiparesis and ipsalateral CNVII symptoms

Question 15

What is this?

Answer 15

Right MCA Infarct

Question 16

What is this?

Answer 16

Right MCA infarct