revision course Flashcards
Upper motor neuron lesion
Upgoing plantars
Hypertonia
Hyperreflexia
From where to where is upper
Cortex to anterior horn cell
Everything ends at which level
L2
Anything below L2 = lower motor neuron
Anterior circulation stroke findings
Hemiparesis
Aphasia
Apraxia
Neglect
Face, arm, leg
Posterior circulation stroke findings
Diplopia
Dysarthria
Dizziness
Dysphagia
Crossed findings
Anterior cerebral artery stroke
Leg>arm affected
Upper motor neuron facial nerve involvement
Forehead spared
Homonymous hemianopia is where
Behind optic chiasm e.g. left occipital lobe if right homonymous hemianopia
Homon
iF symptomatic carotid artery stenosis
Carotid doppler or CTA/MRA - consider carotid endarterectomy
Stroke long term management
Clopi
Stroke long term management if someone has AF
Apixaban
Stroke long term management if someone has more than 70 percent carotid artery stenosis +event
scoring system for stroke and AF for whether you’re going to anticoag them
Chadsvasc score 2 or more for W, 1 or more for M
TIA without AF - mx
Aspirin 300mg 14 days then convert to clopidrogel
Vertigo, right sided intention tremor, dysdiadokinesia etc - which side is the problem?
IPSILATERAL INNERVATION
TIA with AF
Apixaban / DOAC
thrombolysis within 4.5
thrombectomy only if large vessel occlusion
SAH - when do you do LP?
CT negative - ONLY after 12 hours after the onset of the haemorrhage
stroke within 4.5 hrs
Put out a stroke call
Urgent CT head
Don’t give 300mg if thrombolysing - aspirin is only if not within thrombolysis target
Thrombectomy - within 6 hrs
Headache red flags
Age over 50 - GCA
Neuro - Neuro signs, confusion
Onset maximum suddenly
Pattern change - ncreasing frequency
Fever/weight loss
Worse lying flat/coughing/exertion
