Stroke

Question 1

What is lateral medullary syndrome/ Wallenburg’s syndrome?

Answer 1

Stroke affecting cranial nerve nuclei of the medulla
Causing:
Ataxia
Dysarthria
Dysphagia
Ipsilateral Horner’s syndrome
Ipsilateral loss of pain and sensation on the face
Contralateral loss of pain and temperature sensation over the contralateral body

Question 2

What is a stroke also known as?

Answer 2

Cerebrovascular accident - CVA

Question 3

What causes stroke?

Answer 3

Ischaemia or infarction of brain tissue due to inadequate blood supply
Haemorrhage

Question 4

What causes disruption to blood flow in ischaemic stroke?

Answer 4

Thrombus/ emboli
Atherosclerosis
Shock
Vasculitis

Question 5

What would make you suspect a stroke?

Answer 5

Sudden onset neurological symptoms, usually asymmetrical:
Sudden onset facial weakness/ limb weakness
Sudden onset visual disturbance
Sudden onset dysphasia
Sudden onset sensory loss

Question 6

What are the contra-indications to thrombolysis?

Answer 6

HIGH BROW
High BP e.g. diastolic>140
B- bleeding tendency 
R- recent surgery 
O- over 80 years 
W- woke with symptoms

Question 7

Why is it important to assess fever and hyperglycaemia and keep these under control post stroke?

Answer 7

To salvage the ischaemic penumbra

Question 8

Poorly controlled fever & hyperglycaemia post stroke lead to:

Answer 8

Increased metabolism
Acidosis
Threatens the penumbra
Infarct expansion