Stroke Flashcards
what are the three types of stroke
ischaemic stroke (infarction)
haemorrhagic stroke
transient ischaemic attack (TIA)
difference between ischaemic and haemorrhagic stroke
An ischaemic stroke is caused by a blockage cutting off the blood supply to the brain. This is the most common type of stroke. A haemorrhagic stroke is caused by a bleeding in or around the brain
what is the definition of a stroke
rapid permanent neurological deficit from cerebrovascular insult. Also defined clinically, as focal or global impairment of CNS function developing rapidly and lasting > 24 hrs
what is a transient ischaemic attack
stroke that resolves itself in 24 hours
what is the more common type of stroke
85% of strokes are ISCHAEMIC
- infarction
causes of ischaemic stroke
blood supply in a cerebral vascular territory is reduced secondary to stenosis or complete occlusion of a cerebral artery
intracranial small vessel atherosclerosis (25%)
large vessel atherosclerosis (50%) such as carotid artery stenosis
cardio-embolic (20%)- e.g. due to atrial fibrillation throwing a thrombus from the left atrium
risk factors of stroke
age, male sex, FHx, hypertension, smoking, diabetes mellitus, atrial fibrillation,
obesity, poor diet, OCP, hypercholesterolaemia
causes of haemorrhagic stroke
hypertension, Charcot-Bouchard microaneurysm rupture, trauma
symptoms of stroke (GENERAL)
SUDDEN ONSET
weakness, sensory, visual, cognitive impairment, impaired coordination, impaired consciousness, head or neck pain
signs of Lacunar infarcts (ischaemic stroke)
Affecting the internal capsule or pons: pure sensory or motor deficit (or both)
Affecting the thalamus: loss of consciousness, hemisensory deficit
Affecting the basal ganglia: hemichorea, hemiballismus, parkinsonism
signs of anterior cerebral artery stroke
lower limb weakness and confusion (altered mental status)
signs of middle cerebral artery stroke
the classic stroke;
weakness, hemiparesis, hemisensory loss, apraxia, hemineglect, dysphasia
signs of posterior cerebral artery stroke
visual field loss or homonymous hemianopia to the opposite side
investigations
bloods, ECG, echocardiogram, CT head, carotid doppler US, MRI brain
management
ABCDE approach
hyperacute stroke (if less than 4.5 hours from onset)- thrombolysis
aspirin and clopidogrel to prevent further thrombosis
