Neurology 1 - Stroke Flashcards
define cerebrovascular accidents + causes
either
ischaemia / infarction
or bleed
(clots, atherosclerosis, shock, vasculitis)
TIA definition
stroke-like symptoms resolving within 24 hrs with complete recovery of function
‘transient neurological dysfunction secondary to ischaemia but with no infarction’
crescendo TIA
2+ TIAs in one week
v high risk of progressing to stroke
key stroke symptoms
sudden limb weakness
sudden facial weakness
sudden onset dysphasia
sudden onset sensory loss
risk factors for stroke
CVD prev stroke/TIA AF carotid disease HTN diabetes smoking vasculitis throbophilia COCP
FAST tool
face
arm
speech
time to act and call 999
what tool is used for stroke recognition in A+E?
ROSIER scoring tool
what score is used for risk assessment after a TIA?
ABCD2 assesses risk of stroke in next 48 hrs
A age >60 (1) B blood pressure HTN (1) C clinical pic (unilateral weakness (2), dysphasia without weakness (1) ) D duration (1hr+ (2), <10 mins (0) ) D diabetes
management steps in stroke
admit to stroke centre
exclude hypoglycaemia
CT to exclude bleed
stat 300mg aspirin, cont 2 weeks
thrombolysis with alteplase if 4.5 hrs since admission and bleed excluded on CT
monitor with repeat CTs
don’t lower BP as worsens ischaemia
management of TIA
aspirin 300mg daily
cardio secondary prevention
if ABCD2 is 3+, urgent specialist visit
diffusion weighted MRI gold standard
carotid ultrasound
secondary prevention of stroke x 4
clopidogrel 75mg OD
atorvastatin 80mg eventually
carotid endartectomy eventually
treat mod risk factors
stroke rehab
physio, SALT, dietician, OT key
