Neurological conditions and management

Question 1

Why does a stroke happen?

Answer 1

happens when the blood supply to the brain is cut off

Question 2

What does BEFAST stand for?

Answer 2

balance, eyes, face, arms, speech, time.

Question 3

What are the two stroke types?

Answer 3

ischemic, Haemorrhagic strokes

Question 4

What causes an ischemic stroke?

Answer 4

caused by thrombus or embolus obstructing the cerebral circulation - blood vessels becoming blocked.

Question 5

What are the risk factors of an ischemic stroke?

Answer 5

Genetics, smoking, obesity, sickle cell disease, blood pressure, high LCL cholestrol, atrial fibrillation and drugs such as cocaine.

Question 6

What part of the brain suffers in an ischemic stroke?

Answer 6

Only the portion of the brain distal to the block will suffer.

Question 7

What are the signs and symptoms of an ischemic stroke?

Answer 7

Tingling in the arms, slurred speech, motor issues, changes in vision, total loss of vision in one eye, dysphasia and facial droop.

Question 8

How do you assess a possible ischemic stroke?

Answer 8

Primary survey. ABCDE approach and BEFAST.

Question 9

What should you look at to make sure you have done all the checks for a stroke patient?

Answer 9

stroke care bundle

Question 10

What is the percentage for ischemic strokes

Answer 10

Approx 85%

Question 11

What is the second type of stroke

Answer 11

Haemorrhagic

Question 12

How many main types are there of a Haemorrhagic stroke?

Answer 12

Two

Question 13

What is the first type of Haemorrhagic stroke?

Answer 13

Bleeding within the brain cavity itself (intercerebral or intercranial haemorrhage)

Question 14

How does an intercranial haemorrhage work?

Answer 14

Artery within the brain ruptures causing bleeding, leading to a rise in the intercranial pressure.

Question 15

What is the second main type of Haemorrhagic stroke?

Answer 15

Bleeding on the surface, surrounding the cranium, subarachnoid haemorrhage (SAH) - MOST COMMON. most often caused by a burst aneurusym.

Question 16

What risks can cause this type of stroke?

Answer 16

Hypertension

Question 17

What is the treatment for a haemorrhagic stroke?

Answer 17

Medication to reduce hypertension, surgery.

Question 18

What is a transient ischeamic stroke?

Answer 18

“mini stroke”, episode of cerebral ischaemia that do not cause any lasting damage. Presents with signs and symptoms of a stroke but resolve within 24 hours.

Question 19

What is a seizure/ convulsions

Answer 19

An abnormal and excessive depolarisation of a set of neurons in the brain. It sometimes resulting in a period of involuntary muscular or motor contractionas.

Question 20

What is an epileptic seizure?

Answer 20

A neurological condition resulting in a possible convulson. Includes persistent and continous seizure lasting 30 mins max termed.

Question 21

What is a Eclamptic seizure?

Answer 21

Occurs prenatually and is associated with pregnancy hypertension.

Question 22

What is a ferbrile induced seizure?

Answer 22

Generally very young children, caused by a fever.

Question 23

What is epilepsy?

Answer 23

A neurological disorder marked by a sudden recurrent episode of sensory disturbance, loss of consciousness or convulsions.

Question 24

What are some epilepsy triggers?

Answer 24

Not taking, feeling tired, not sleeping well, stress, alcohol or recreational drugs, missing meals, fever.

Question 25

What is a psychogenic non epileptic seizures (PNES)?

Answer 25

Involuntary psycholigical response to distress, commonly associated with emotional trauma. involves attacks that resemble epilepsy-related seizures in symptoms and signs, but abnormal electrical activity in your brain doesn’t cause them.

Question 26

What is ineffective with PNES?

Answer 26

Drug therapy

Question 27

What is meningitus?

Answer 27

Inflammation of the membranes that cover the brain and spinal cord called the meninges.

Question 28

Can meningitus be both bacterial and virus?

Answer 28

Yes if it is bacterial it is a communicable disease and is spread via droplets and must be reported to PHE.

Question 29

What are signs and symptoms of meningitus?

Answer 29

Classic features include neck stiffness, photophobia, haemorrhagic rash. Non specific signs include nausea, vomiting and a sore throat. Other signs include a fever, rigors and tachycardia.

Question 30

What is the management of menigitus?

Answer 30

ABCDE approach, Oxygen maintain sats between 94% to 98%. IV fluids, benzylpenicllin. Time critical transfer and a handover.

Question 31

What is a cluster headache?

Answer 31

excruciating unilateral pain with parasympathetic autonomic activation in the same eye.

Question 32

What does a cluster headache cause?

Answer 32

Redness or tearing of the eye, nasal congestion.

Question 33

How long do the attacks last for a cluster headache?

Answer 33

30-90mins and they can occur several times a day. It lasts for 1 to 2 months before stopping and happening again a year later.

Question 34

What is the management for cluster headaches?

Answer 34

Analgesics are unhelpful, subcutaneous sumatriptan helps for acute treatment. High flow oxygen also used.

Question 35

What is a tension type headache similar too?

Answer 35

A migraine

Question 36

What happens in a tension type headache?

Answer 36

Pain is usually mild to moderate severity with tight band sensations, pressure behind the eyes and bursting sensations.

Question 37

What helps a tension type headache?

Answer 37

Simple analgesics are often effective (paracetamol, aspirin, NSAIDS(ibroprofen)). Physical treatment such as ice packs may help.

Question 38

What is a migraine?

Answer 38

Episode of headache that is associated with the sensativity like light, sound or movement and sometimes causes nausea or vomiting.

Question 39

How does a migraine occur?

Answer 39

Happens by a wave of depolarisation followed by depressed acitivty slowly spreading anterioly across the cerebral cortex from the occipital region. Activation of the trigeminal pain neurons is the basis of the headache.