Stroke 1 Flashcards
Risk Factors
Age, previous stroke/ TIA, family history
Medical conditions that can cause stroke
Hypertension
Arteriosclerosis/ high cholesterol
Heart disease
Primary stroke prevention
- treat hypertension
- stop smoking
- manage weight
- increase exercise
- lower cholesterol
- control diabetes
What are the main types of stroke?
Ischaemic and Cerebral haemorrhage
Ischaemic stroke
Blockage cutting off brain blood supply
Cerebral haemorrhage
Burst blood vessel causing bleeding within the brain
What are the 3 main arteries associated with the circle of Willis?
Internal carotid
Middle cerebral
Basilar artery
MRI T2
Sensitive to difference between intact and damaged tissue
What is an ischaemic penumbra?
Infarcted areas where blood flow is reduced
What is lysis?
Dead cell membranes break down
Types of ichaemic stroke
Thrombotic
Embolic
Lacunar
Thrombotic stroke
Due to atherosclerosis
Deposition of lipid fats in muscle cells in the artery wall
Embolic stroke
Part of embolus- blood clot, plaque deposit, air bubble
Lacunar
Blockage of small artery- arteriole
TIA
Often called mini stroke
Effects last less than 24 hours
Intervention for TIA
Reduce blood pressure
Address lifestyle factors
How does low dose aspirin prevent stroke?
Blood thinning effects- reduces risk of blood clots
Cerebral haemorrhage
Massive bleed into brain tissue
Effects of cerebral haemorrhage are due to?
Mass displacement of brain tissue
Increased intracerbral pressure
Destruction at site of bleeding
Arteriovenous malformations
Congenital collections of abnormal blood vessels
Aneurysms
Vascular dilations rising from localised defects in elasticity
Types of cerebral haemorrhage
Intracerabeal
Subarachnoid
Subdural
Intracerbral haemorrhage
- raised intracerbral pressure
Subdural haemorrhage (haematoma)
Contact via head injuries
Where does the Anterior circulation start from?
Internal Carotid Artery (ICA)
What large vessels are associated with the anterior circulation?
Middle cerebral server
Anterior cerebral artery
What are the small vessels associated with anterior circulation?
Branches from the MCA and the ACA
Where does the posterior conciliation start from?
From vertebral arteries
What are the large vessels associated with posterior circulation?
Basilar artery
Posterior cerebral artery
Dysarthria
Muscular control of articulation
Which part of the brain is damaged associated with dysarthria?
Damage to the brain stem/ medulla
Apraxia
Planning of speech motor commands
What part of the Brian damage is associated with apraxia ?
Diverse cortical and sub-cortical lesions
What are the two types of stroke dysphagia is common after?
Brain stem stroke
Cortical stroke
What does the Anterior carotid artery supply?
Prefrontal cortex
What is the function of the cingulate gyrus?
Emotion regulation and motivation
Where does the middle cerebral artery branch at?
Lateral sculls (Sylvian fissure)
What are of the Brian is most commonly affected in ischaemic cerebral strokes?
Middle Cerebral artery
What part of the brain does the MCA supply most?
Most of the lateral surface of the cortex, including wernickes area and heschl’s gyrus
The basil ganglia and the insular cortex are supplied by which cerebral artery?
MCA
Symptoms of MCA stroke
- facial palsy/upper limb paralysis
- bilateral innervation to muscles of articulation
- hemispatial neglect
What area of the brain does the posterior cerebral artery supply?
Ventral arterial and ventromedial temporal lobe
The ventromedial and ventral lateral temporal lobes are associated with what?
Semantic processing, long-term memory
Bamford stroke classification system
Total anterior circulation stroke
Partial anterior circulation stroke
Lacunar syndrome
Posterior circulation syndrome
TACS
3 of the following:
- unilateral weakness
- homonymous hemianopia
- higher cerebral dysfunction
