Stroke 1 Flashcards
What percent of body weight does the brain make up?
2%
The brain requires around ____ percent of your cardiac output in order to receive sufficient oxygen.
15
How much oxygen does your brain require?
About 20% of the body’s total oxygen.
Describe the arteries that supply the brain and where they supply them.
Internal Carotid arteries supply the anterior 3/5ths of the brain.
Vertebral arteries join to form the Basilar artery and it supplies the posterior 2/5ths of the brain which contains the cerebellum and brainstem.
Describe neurons energy supply in the brain. What do they require? What happens if they do not get the required amount?
They are mostly aerobic and require oxygen and glucose. They need a continuous supply because they are not able to store glucose or oxygen. If they do not receive it within a few minutes, it could lead to irreversible injury.
If oxygen and glucose are depleted in the brain, what would this create?
Oxidative Stress
If brain experiences ischemia, what could this cause?
mitochondrial dysfunction
If the brain has excess glutamate, what could this cause?
Glutamate can act as a neurotoxic neurotransmitter and can cause cell death.
If the brain has excess intracellular calcium, what could this cause?
Cell injury/death
If the brain has a lot of ROS, what could this cause?
mitochondrial dysfunction
If the brain undergoes re-perfusion injury of vessels, what could this lead to?
An increase in ROS which could lead to mitochondrial damage.
Definition of Transient Ischemic Attack (TIA).
A brief period of inadequate cerebral blood flow.
How long does a Transient Ischemic attack last?
Usually has rapid onset and resolves within 5 minutes.
How long does it take to fully recover from TIA?
within 24 hours
What is the difference between a TIA and a mini-stroke?
a TIA has no permanent defects
a mini-stroke is a series of small strokes that have permanent defects
What causes a transient ischemic attack? (2)
Intermittent vessel obstruction caused by clots, thrombosis, or plaques.
Temporary vasospasm due to drugs, stress, smoking, and migraines can also cause TIAs.
Within one year, ___ of patients experiencing a TIA will have a full blown stroke if left untreated.
35%
TIA symptoms (7)
1) Hemiplegia/paresis (paralysis) of arm, leg, face
2) Diplopia
3) Transient loss of vision (Amaurosis fugax)
4) Vertigo
5) Loss of speech
6) Loss of understanding
7) Loss of balance
What may lead us to diagnose TIA? (DDX - differential diagnosis) (3)
Migraines
Seizures
History of similar episodes
Symptoms that may defer us from diagnosing a TIA. (5)
1) Lightheadedness
2) Tightness in the chest
3) Stomach upset
4) History where TIA was ruled out
5) Speed of onset. If slow, not a TIA.
How to check if someone is having a TIA.
Carotid auscultation with a stethoscope. Will sound like a whooshing sound.
Carotid ultrasound. Will appear colder color and can see plaque blocking the vessel.
Echocardiogram
Definition of Stroke
A disturbance of blood supply causing loss of brain function that leads to permanent damage to neurons.