Stroke

Question 1

what score can be used to assess the likelihood of a stroke?

Answer 1

ROSIER score

any score >0 = stroke likely
a score <0 does not exclude stroke

Question 2

what is the first line imaging done in a suspected stroke?

Answer 2

head CT

Question 3

describe how bleeds show up on a head CT

Answer 3

acute = bright white

not sensitive for blood after about a week

Question 4

describe how infarcts show up on a head CT

Answer 4

take longer to show up - oedema seen after a few hours

Question 5

describe how a blood clot in an artery can show up on a head CT

Answer 5

very acutely

arteries appear white if occluded as the blood is static

Question 6

when are MRI’s sensitive for showing an acute infarct?

Answer 6

up to ten days

can appear normal after this time period

Question 7

how do acute infarcts show up on MRI?

Answer 7

bright white area

Question 8

what are the two initial treatment options for an ischaemic stroke to restore blood flow?

Answer 8

thrombolysis

thrombectomy

Question 9

what is thrombolysis?

Answer 9

drug treatment that breaks down a clot

given IV

Question 10

what is thrombectomy?

Answer 10

surgically going into a vessel and pulling the clot out

done for large vessel occlusions

Question 11

what potential factors can influence whether thrombolysis is an appropriate management option for a patient with a stroke?

Answer 11

age
time since onset
previous ICH/stroke
atrophic changes
BP
diabetes
potential benefit

Question 12

what antiplatelet should be administered ASAP after stroke?

Answer 12

aspirin 300mg

after bleed excluded

Question 13

what is a TIA?

Answer 13

stroke symptoms for less than 24 hours