Stroke Flashcards
what is an ischaemic stroke
blocked artery reducing blood flow to brain
Most common type of stroke
Ischaemic
Damage from ischaemic stroke ..
dependant on location of blockage and how long suffers
IE if self resolves in 24 hours it is a TIA
Two causes of ischaemic stroke
- endothelial cell dysfunction- inflamed of irritated endothelium- tunica intica
irritants (smoking) cause formation of atherosclerosis causing obstruction after -plaques dislodging exposing thrombogenic core which then form clots - embolism - blood clot breaks off and then gets lodged in an artery downstream (if in heart will be in left side of heart unless atrial septal defect)
common areas for brain atherosclerosis formation are
branch areas
particularly internal carotid and middle cerebral
there usually take years to form
epidemiology of strokes
110000 people have strokes
uncommon under 40
males> females
incidence falling due to primary care - statins and bp checks
Causes of ischaemic stroke
atherosclerosis large artery stenosis cardiac emboli from AF, MI or infective endocarditis causing blood stasis shock- reduced blood flow vasculitis
Risk factors
Male black or Asian hypertension smoking age previous TIA alcohol heart disease atrial fibrillation
signs of stroke
slurred speech
arm/leg weakness
facial dropping
act FAST
symptoms dependant on location
MCA- middle cerebral artery
provides to temporal mostly
contralateral motor weakness- arms and legs
hemiplegia - paralysis of one side of body
contralateral sensory loss
aphasia- can understand (wernickes) or produce speech (brocas)
dysphagia- speech problems if in dominant hemisphere
facial droop
symptoms depend on location
ACA - anterior cerebral artery infarction
frontal
contralateral weakness and sensory loss of lower limb
truncal ataxia- wide drunken gait - uncertain steps, lateral deviations and unequal steps
incontinence
drowsiness
logical thinking
personality
symptoms depend on location
PCA- posterior cerebral artery infarction
occipital
disorders of perception
contralateral homonymous hemianopia - ie cant see on right side in both eyes
symptoms depend on location
vertebrobasilar artery - more catastrophic that PCA as more areas are supplied
disorders of balance
coordination disorders
symptoms depend on location
cerebral hemisphere infarction
most common infarction of internal capsule following occlusion of a branch from MCA
weakness and paralysis of one side
aphasia
cognitive impairments
symptoms depend on location
brainstem infarction
lateral medullary syndrome
caused by occlusion of posterior inferior cerebellar artery
sudden vomiting
vertigo
ipsilateral horners syndrome - hypohydrosis facial numbness dysarthria limb ataxia and dysphagia
contralateral loss of pain and temp sensation
