Ischaemic Stroke Flashcards
Types of stroke
Ischaemic stroke = blocked artery
Haemorrhagic stroke= artery breaks
More common stroke
Ischemic
Damage depends on
Location and time
If symptoms resolve in 24 hours then it is a?
Risk is?
Transient ischemic attack
Minimal long term damage
Right cerebrum controls ?
Muscles on left side of the body and vice versa
Function of lobes
Frontal- movement /executive function
Parietal- sensory info
Temporal - hearing, smell, memory, language, facial recognition
Occipital- vision
Cerrebellum- muscle coordination + balance
Brain stem- HR, BP, Breathing, GI, consciousness
Back of brain supplied by
Basilar artery
Vertebral artery (internal carotid artery) supplies
Frontal+ parental parts of the brain
Brain arteries connected by
Circle of Willis
Collateral circulation
Blood can flow around circle of Willis to provide blood for any part of the brain that is under supplied
Can overcome gradual blockage
Endothelial cell dysfunction ? Explained
IritNts damage endothelium (tobacco)
Damage site becomes site for artherosclerosis
Plaque forms and obstructs blood flow
Most common sites for atherosclerosis
Branch points of the internal carotid + middle cerebral arteries
Which plaques are more dangerous
Small plaques
Fibrous cap ripped off
Thrombogenic plaque left behind
Within a minute the artery can be duly blocked
2 ways of ischemic stroke
Endothelial cell dysfunction
Embolism
Embolism explained
Blood clot breaks off and gets lodged in another location
What causes stagnant blood
AF OR MI
What does stagnant blood form
Blood clot
Blood clot in left atrium leads to
In right vertical leads to
Left = brain
Right= lungs
If septal defect then clot can go to any side
Lacunar stroke most commonly where
Middle cerebral artery deep branches
Damaged brain forms cysts that look like lakes
Lacunar cysts form due to
Hyaline arteriosclerosis
When 02 diminished in body for any reason what happens
Up have a watershed infarct in your brain
Ischemic Core
Tissues die due to ischemia
Ischemic penumbra
Preserved by collateral circulation may survive I’d restored early enough
High NA
+ high CA2+ means what in cells
NA = oedema
Ca2+= reactive oxygen species
Damaged mitochondria + lysosome release apoptosis inducing factors
Inflammation does what
Damages the blood brain barrier
Fluid + protein enter brain
(Vasogenic edema)
Swollen brain means
Swollen tissue push into the unaffected side of the brain
Causing cingulate/ uncalled herniation
Or slips out of base of skull (cerebellar tonsil herniation)
Can push into brainstem and affect breathing + consciousness
Stroke in
Anterior /middle cerebral artery
Broca region
Wernickes area
Posterior cerebral artery stroke
Numbness/swollen muscles weakness
Slurred speech
Difficulty understanding speech
Vision
Stroke symptoms s
FAST
Face droop
Arm weakness
Speech difficulty
time to get help quick
Diagnosis
Ct or mri
Angiography to look at where blood is
Flair to distinguish old stroke from new
Treatment
Thrombolectic enzymes
TPa (activates clotting enzymes) has time limit for usage
Aspirin- prevents clotting
Surgery if TPA doesn’t work
Minimise risk how
Quit smoking
Healthy bp
Normal LDL cholesterol
Control diabetes
Surgical treatments
Clean attires
Carotid endarterectomy
Stent - placed to keep artery open
