neuro top tier Flashcards
what investigation can be done to assess type of stroke
what does this affect
CT stroke - allows you to see if haemorrhagic.
if not (=embolic) then lytic medicine given so embolus broken down and damage reduced. but if it is haemorrhagic, then lytic medicine should be avoided as this would increase the bleed
effect on ischaemia to broca’s area
expressive dysphasia (motor)
effect on ischaemia to wernicke’s area
receptive dysphasia (sensory) - misinterpret own speaking and you think it is wrong \+ can't understand other people's communication
is someone more likely to recover from a large ischaemic (embolic) or haemorrhagic stroke?
haemorrhagic
in haemorrhagic- the axons are disturbed (lenticular striate arteries cross internal capsule) but cell bodies are not affected- so necrosis. so as the haemorrhage resolves (With macrophages ), the pressure on axons decreases allowing recovery
with embolic blockage- there is necrosis of cell bodies. these are unable to regenerate and so are non-recoverable
in terms of the motor homunculus- which areas are supplied to which arteries (and so which areas would suffer from a stroke blockage in this artery)
anterior cerebral arteries = medial of cerebrum and homunculus
– lower limb
middle cerebral arteries = lateral of cerebrum
– upper limb and face
which is more common, embolic or haemorrhagic stroke?
85% embolic
15% haemorrhagic
which side of the brain is more likely to be affected by embolus from heart / carried in heart and why
right brain
R common carotid comes of before L from arch of aorta
name 3 significant causes of embolic stroke
1 heart failure (AF –> stasis –> embolus –> ejected when sinus rhythm returns)
2 blood pressure (stretches artery /longer –> turbulent blood flow –> clot embolus)
3 also kidney/lung/liver failure
what drugs may be given to AF patient for stroke prophylaxis
warfarin - prevent clot formation
where may a clot form with AF
in auricular appendage of atria in heart (Stasis of blood)
where does external carotid supply
dura
skull
face
neck
where does internal carotid supple
circle of willis
which vessels lie extradurally
meningeal arteries
which vessels lie subdurally
bridging veins
which vessels lie subarachnoidly
circle of willis
what symptoms is associated with a subarachnoid haemorrhage
thundeclap headache
what is the main cause of a subarachnoid haemorrhage
berry anerysrm in circle of willis
which haemorrhage type would cause dura to be pushed away from bone
extradural - meningeal
which groups are more suscpetible to subdural haemorrhage
elderly
children
alcoholics
they have brains smaller than their ckulls
epidemioloogy of migraines
common
f>m
<40y. most have 1st in adolescence
epidemiology of tension headaches
very common
f>m
epidemiology of cluster headaches
m>f
<40y
disabling
triggers for migraine
chocolate:
chocolate hangover orgasm cheese oral contraceptuve lie ins alcohol tumult exercise
triggers for tension headache
stress sleep deprivation bad posture hunger eyestrain anxiety noise