Neurology Flashcards
2 types of stroke?
Ischaemic
Haemorrhagic
What can cause a disruption of blood supply that causes a stroke?
Thrombus formation or embolus
Atherosclerosis
Shock
Vasculitis
What is a TIA?
Transient Ischaemic Stroke
Ischeamic stroke that doesn’t cause infarction
What is a crescendo TIA?
When there are 2 or more TIAs within a week
Presentation of stroke?
Sudden onset
Symptoms typically asymmetrical
Sudden weakness of limbs
Sudden facial weakness
Risk factors for stroke
CVD like angina, MI and PVD Previous stroke/TIA AF Carotid artery disease Hypertension Diabetes Smoking Vasculitis Thrombophilia Contraceptive pill
Management of stroke?
Admit to specialist stroke centre
Exclude hypoglycaemia
Immediate CT brain to exclude haemorrhage
Aspirin 300mg stat
If ischeamic, thrombolysis with alteplase can be used to rapidly break down clots - needs to be given within 4.5hrs
Management of TIA?
300mg aspirin daily
Start 2* prevention measures for CVD
Perform ABCD2 score
What does ABCD2 stand for?
Age BP Clinical features Duration Diabetes
2* prevention of stroke?
Clopidogrel 75mg OD
Atorvastatin 80mg
Carotid stenting in patients with carotid artery disease
Treat modifiable risk factors
What can cause intracranial bleeds?
Head injury Hypertension Aneurysm Ischaemic can progress to haemorrhage Brain tumour Anticoagulants like warfarin
Presentation of intracranial bleeds?
SUDDEN ONSET HEADACHE
Seizures
Weakness
vomiting
Reduced consciousness
Location of extradural and subdural haemorrhage
Extradural - between skull and dura mater
Subdural - between dura mater and arachnoid mater
What causes a subdural haemorrhage
Rupture of the bridging veins (Usually seen in elderly and alcoholics)
Can cross over cranial sutures
Cause of extradural haemorrhage
Rupture of the middle meningeal artery (usually head trauma)
Can’t cross over cranial sutures
