neurology

Question 1

What is a stroke

Answer 1

A stroke aka CVA happens when brain lacks oxygen due to a sudden interruption in the vascular supply resulting in long-term permanent damage

Question 2

2 types of stroke

Answer 2

Ischaemic and Haemorrhagic

Question 3

What is a TIA

Answer 3

A type of ischaemic stroke with a period of transient cerebral ischaemia (without infarction) resulting in a neurological deficit that is self-resolving within 24 hours

Question 4

What is a crescendo TIA

Answer 4

where there are 2 or more TIAs in a week which puts pt at higher risk of stroke

Question 5

Types of haemorrhagic stroke

Answer 5

Intraparenchymal: Intracerebral and Intraventricular (premature infants more @ risk)
SAH (subarachnoid haemorrhage)

Question 6

what % of all strokes are Ischaemic

Answer 6

85%

Question 7

categories of ischaemic stroke

Answer 7

thrombotic, embolic, lacunar

Question 8

what leads to ishcaemic stroke

Answer 8

Reduction in cerebral blood flow due to arterial occlusion or stenosis (thickening + hardening)

Question 9

causes of ischaemic stroke: Cardiac

Answer 9

cardiac embolisms:
AF (stagnant blood flow → clots)
Atherosclerosis (HTN, diabetes, smoking, high cholesterol)
Septal defect e.g patent formaen ovalae or ASD ‘paradoxial embolism’

Question 10

causes of ischaemic stroke: Vascular

Answer 10

Aortic dissection
Vasculitis
Vertebral dissection

Question 11

causes of ischaemic stroke: Haematological

Answer 11

hypercoagulability (APS)
sickle cell anaemia
polycythemia (hyperviscous blood)

Question 12

causes of haemorragic stroke: SAH

Answer 12

trauma
berry aneurysm
AVM

Question 13

causes of haemorrhagic strokes: intracerebral

Answer 13

AVM
Cerebral amyloid (beta amyloid protein build up)
HTN

Question 14

what 2 haemorrhages are not classified as haemorrhagic stroke

Answer 14

extradural and subdural haemorrhage

Question 15

other cause of ischaemic stroke

Answer 15

infective emboli: bacterial endocarditis

Question 16

Risk factors for stroke

Answer 16

HTN
age (most important non-modifiable risk)
previous stroke/TIA
CVD (angina, MI, PVD)
smoking 
diabetes
hyperlipidaemia  
AF
carotid artery stenosis 
haematological disease (e.g sickle cell)
Thrombophilic disorders (e.g. antiphospholipid syndrome)
FHx
HRT or COCP

Question 17

what is the single greatest RF for stroke

Answer 17

HTN

Question 18

where does the anterior circulation of the brain come from

Answer 18

BVs arising from the internal carotid arteries

Question 19

where does the posterior circulation of the brain come from

Answer 19

BVs arising from the vertebrobasilar arteries

Question 20

ACA supplies

Answer 20

frontal and parietal lobe (part of the anterior circulation of the brain)

Question 21

MCA supplies

Answer 21

Large proportion of the lateral surface of each brain hemisphere including the internal capsule and basal ganglia.
Most common site of infarction.
Forms part of the anterior circulation of the brain

Question 22

PCA supplies

Answer 22

Occipital lobe and inferior proportion of the temporal lobe as well as some deep structures (e.g. thalamus).