L20: Clinical aspects of stroke

Question 1

stroke=

Answer 1

a sudden focal neurological deficit due to a vascular lesion lasting longer than 24hrs

Question 2

Transient ischaemic attack (TIA)=

Answer 2

a focal deficit lasting a few seconds to 24 hours, there is complete clinical recovery

Question 3

percentage of people with left hemisphere dominance

Answer 3

96%

Question 4

which lobe is broca’s area in

Answer 4

frontal lobe

Question 5

prefrontal areas=

Answer 5

personality

initiative

Question 6

4 things happening in the frontal lobe

Answer 6

• contralateral movements
• broca’s area
• prefrontal area (personality/ initiative)
• cortical inhibition of bladder and bowels

Question 7

3 things in parietal lobe

Answer 7

• sensory cortex
• wernicke’s area
• visual pathways

Question 8

in the dominant parietal lobe=

Answer 8

handling numbers, calculations

Question 9

in the non dominant parietal lobe=

Answer 9

concept of body image and awareness of external environment

Question 10

5 things in the temporal lobe

Answer 10

• auditory cortex
• learning and memory
• olfactory sensation
• emotional behaviour
• visual pathways

Question 11

occipital lobe function

Answer 11

visual cortex

Question 12

what blood supply is there to the brainstem

Answer 12

vertebrobasilar territory

Question 13

cause of 80% of strokes =

Answer 13

ischaemic

Question 14

cause of 20% of strokes=

Answer 14

Haemorrhagic

Question 15

3 causes of an ischaemic stroke

Answer 15

• narrowed arteries
• cardiac source of embolism
• intracranial small vessel disease

Question 16

what is a haemorrhage

Answer 16

artery that pops and ruptures blood into the brain

Question 17

2 type of brain haemorrhage

Answer 17

parenchymal or subarachnoid

Question 18

what is a perforating vessel stroke called

Answer 18

lacunar infarction

Question 19

what protein is responsible for weakening of blood vessels

Answer 19

Amyloid angiopathy

Question 20

what does one side of middle cerebral artery being blocked cause (5)

Answer 20

• contralateral hemiplegia
• homonymous hemianopia
• deterioration in consciousness
• gaze palsy
• global aphasia (dominant hemisphere)

Question 21

what is hemiplegia

Answer 21

paralysis of half of the body

Question 22

what is homonymous hemianopia

Answer 22

loss of half of the field of vision on both eyes on the same side

Question 23

what is gaze palsy

Answer 23

eyes deviation to the side of the lesion

Question 24

dominant hemisphere effect of MCA stroke

Answer 24

• aphasia
• acalculia (loss of calculations)
• agraphia

Question 25

non dominant hemisphere MCA stroke

Answer 25

• neglect
• dressing apraxia
• failure to recognise faces

Question 26

what happens in a perforating vessel stroke

Answer 26

very concentrated effects (can get whole motor gone) but no complicated cortical affects

Question 27

what areas of the brain are affected in a vertebral or basilar artery (posterior circulation) stroke

Answer 27

• medulla
• pons
• cerebellum

Question 28

symptoms of a posterior circulation stroke

Answer 28

• vertigo
• ataxia
• sensory loss
• hemianopia

Question 29

TACI=

Answer 29

total anterior circulation stroke

Question 30

PACI=

Answer 30

partial anterior circulation stroke

Question 31

LACI=

Answer 31

lacunar stroke

Question 32

POCI=

Answer 32

posterior circulation stroke

Question 33

infarct treatment

Answer 33

thrombolysis with tPA, then aspirin and statin

Question 34

tPA=

Answer 34

tissue plasminogen activator

Question 35

haemorrhage treatment

Answer 35

lower Bp to <160/90 and reverse anticoagulation