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Year 4 - Neurology and Special Senses > Neurology - Stroke and TIA > Flashcards

Neurology - Stroke and TIA Flashcards

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1
Q

What are the two types of cerebrovascular accidents?

A

Ischaemia or infarction
Disrupted blood supply to brain tissue

Intracranial haemorrhage
Bleeding in or around brain

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2
Q

What can disrupt blood supply to the brain?

A

Thrombus or embolus
Atherosclerosis
Shock
Vasculitis

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3
Q

What is a TIA?

A

Temporary neurological dysfunction caused by ischaemia without infarction

Symptoms have rapid onset

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4
Q

What is a crescendo TIA?

A

Two or more TIAs within a week indicating high risk of stroke

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5
Q

How do strokes present?

A
  • Limb weakness
  • Facial weakness
  • Dysphasia (speech disturbance)
  • Visual field defects
  • Sensory loss
  • Ataxia and vertigo (posterior circulation infarction)
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6
Q

What are the risk factors to a stroke?

A
  • Previous stroke or TIA
  • AF
  • Carotid artery stenosis
  • Hypertension
  • Diabetes
  • Raised cholesterol
  • FH
  • Smoking
  • Obesity
  • Vasculitis
  • Thrombophilia
  • COCP
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7
Q

What is used to identify stroke in the community?

A

FAST tool

Face
Arms
Speech
Time

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8
Q

What scoring tool is used in hospital?

A

ROSIER Tool

Recognition
Of
Stroke
In
Emergency
Room

Stroke possible in scores over 1

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9
Q

How are TIAs managed?

A
  • Daily aspirin 300mg
  • Referral for specialist assessment within 24 hours (within 7 days if more than 7 day since)
  • Diffusion-weighted MRI scan
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10
Q

What is the initial management of a stroke?

A
  • Exclude hypogylcaemia
  • Immediate CT brain to exclude haemorrhage
  • Aspirin 300mg daily for two weeks after haemorrhage excluded with CT
  • Admission to stroke centre
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11
Q

How long after onset should alteplase be given?

A

Within 4.5 hours of symptom onset

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12
Q

When is thrombectomy considered?

A

In patients with confirmed blockage of proximal anterior or posterior circulation

Considered within 24 hours of symptom onset alongside IV thrombolysis

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13
Q

In ischaemic stroke what happens when blood pressure is lowered?

A

Worsen ischaemia

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14
Q

When is high blood pressure treatement indicated?

A

Hypertensive emergency

Reduce risks when giving IV thrombolysis

BP is aggressively treated in haemorhhagic stroke

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15
Q

What potential underlying causes are investigated in patients with TIA or stroke?

A

Carotid artery stenosis
Carotid artery stenosis
Carotid endarterectomy
Angioplasty and stenting

AF
ECG
Give anticoagulation

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16
Q

What secondary prevention is given for strokes and TIAs?

A
  • Clopidogrel 75mg once daily
  • Atorvastatin 20-80mg
  • Blood pressure and diabetes control
  • Address risk factors
17
Q

What is an alternative to clopidogrel?

A

Aspirin + dipyridamole

Year 4 - Neurology and Special Senses (1 decks)

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