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Medicine > Stroke > Flashcards

Stroke Flashcards

1
Q

Most Common Clinical Manifestation of CVD

A

Stroke

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2
Q

3rd most common cause of death in high income countries

A

CVD

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3
Q

Most common cause of severe physical disability

A

CVD

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4
Q

Arterial supply of the brain

A

Internal Carotid - anterior brain
Vertebrobasilar system - brain stem, mid-brain and cerebellum
Frontal and Parietal lobes - anterior and middle cerebral arteries
Occipital lobe - posterior cerebral artery

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5
Q

Mainstay of Stroke Imaging

A

Computed Tomography (CT) scan

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6
Q

Indication for MRI

A
  • diagnostic uncertainty
  • delayed presentation
  • more information on brain structure and function required
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7
Q

Vascular imaging techniques

A

Doppler Scanning
MR Angiography
Intra-arterial Angiography

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8
Q

Blood tests

A

Blood glucose
Lipid profile
FBC

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9
Q

Dysphasia

A

Damage to the dominant frontal or parietal lobe

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10
Q

3rd most common cause of death in high income countries

A

CVD

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11
Q

Most common cause of severe physical disability

A

CVD

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12
Q

Arterial supply of the brain

A

Internal Carotid - anterior brain
Vertebrobasilar system - brain stem, mid-brain and cerebellum
Frontal and Parietal lobes - anterior and middle cerebral arteries
Occipital lobe - posterior cerebral artery

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13
Q

Mainstay of Stroke Imaging

A

Computed Tomography (CT) scan

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14
Q

Indication for MRI

A
  • diagnostic uncertainty
  • delayed presentation
  • more information on brain structure and function required
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15
Q

Vascular imaging techniques

A

Doppler Scanning
MR Angiography
Intra-arterial Angiography

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16
Q

Blood tests

A

Blood glucose
Lipid profile
FBC

17
Q

Dysphasia

A

Damage to the dominant frontal or parietal lobe

18
Q

Presenting Problems

A

Weakness: unilateral weakness, reduced reflexes initially then increased later on with spastic increased tone, UMN weakness of the face is often present

Speech disturbance: dysphasia, dysarthria

Visual deficit

Visuo-spatial dysfunction - damage time the non-domination cortex results in contra lateral vision-spatial dysfunction such as sensory or visual neglect and apraxia

Ataxia

Headache

Seizure - unusual in stroke but may be generalized or focal in cerebral venous disease

Coma - occurs with a brain stem event, of present in the first 24 hrs, it indicates a subarachnoid or intracerebral hemorrhage

19
Q

Is stroke a medical emergency?

A

Yes

20
Q

Non-modifiable Risk factors of stroke

A

Age >65yrs

Gender: male>female except at extremes of age

Race: Afro-Caribbean> Asian> European

Previous vascular event: MI, Stroke, PVD

Heredity

High fibrinogen

21
Q

Modifiable risk factors

A

Blood pressure

Cigarette smoking

Hyperlipidemia:

Heart disease: AFib, MI, CCF, infective endocarditis

DM - makes blood vessels hard and stiff and damaged blood vessels

Excessive alcohol intake

Oestrogen containing drugs: OCP, HRT

Polycythemia

22
Q

How does hypertension lead to stroke

A

Hyaline arteriolosclerosis: hardening and stiffening if blood vessels with eventual narrowing and blockage- ischemic stroke

Aneurysms - hemorrhagic stroke

23
Q

How does hyperlipidemia lead to stroke

A

LDL cholesterol accumulated in damaged parts of the blood vessel and induce formation of blood clots or break off and embolise a smaller vessel

24
Q

Compensatory mechanisms of Infarction

A
  1. Infarction can be delayed by opening of anastomotic channels from other arterial territories that restore perfusion to its territory
  2. Reduction in perfusion pressure leads to compensatory homeostatic changes to maintain tissue oxygenation, sometimes preventing the occlusion of a carotid artery from having any clinically apparent effect
25
Q

Causes of cerebral infarction

A

-thromboembolic disease secondary to atherosclerosis in the major extracranial arteries (carotid artery and aortic arch).

20% due to embolism from the heart

Another 20% due to thrombosis in situ caused by intrinsic disease of small perforating vessels (lenticulostriate arteries), producing lacunar infarctions.

5% due to vasculitis, endocarditis and cerebral venous disease

26
Q

Ischemia occurs when

A

The homeostatic mechanisms fail and leads to infarction unless vascular supply is restored

27
Q

Most common cause of stroke

A

Cerebral Infarction

Medicine (7 decks)

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