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Neuro > Stroke > Flashcards

Stroke Flashcards

1
Q

What vessel is affected when a stroke presents with:

Contralateral hemiparesis and sensory loss.
Lower limbs affected more than upper?

A

Anterior cerebral artery

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2
Q

What vessel is affected when a stroke presents with:

Contralateral hemiparesis and sensory loss.
Upper limbs affected more than lower.
Contralateral homonymous hemianopia
Aphasia

A

Middle cerebral artery

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3
Q

What vessel is affected when a stroke presents with:

Contralateral homonymous hemianopia with macular sparing
Visual agnosia

A

Posterior cerebral artery

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4
Q

What vessels are occluded when a stroke presents as follows:

Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity

What is the name given to this type of stroke?

A

Posterior branches of cerebellar artery that vascularise midbrain.

Weber’s syndrome

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5
Q

A stroke to the basilar artery may cause what type of presentation?

A

Locked-in syndrome

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6
Q

What type of stroke presents with the following:

Isolated hemiparesis
Hemisensory loss
Hemiparesis with limb ataxia

A

Lacunar stroke

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7
Q

How long after a stroke may a statin be commenced?

A

After 48 hours

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8
Q

If a stroke patient has AF, how soon after the stroke may anticoagulation be initiated? (assuming haemorrhage stroke has been ruled out)

A

After 14 days

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9
Q

Under what conditions should aspirin 300mg be prescribed for stroke?

A

Acute management of stroke.

When haemorrhagic stroke has been ruled out with CT.

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10
Q

What is the drug used for thrombolysis in stroke? What time-frame must it be performed within?

A

Altepase

Within 4.5 hours

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11
Q

Under what conditions may thrombectomy be used?

A

If there is a proximal anterior circulation infarct demonstrated by CTA or MRA and it has been < 6 hours since onset, or <24 hours if there is still salvageable brain tissue as demonstrated by CT perfusion scan or diffusion-weighted MRI.

OR

If there is a proximal posterior circulation infarct (basilar or PCA); and it is <24 hours since onset; and there is still salvageable brain tissue as demonstrated by CT perfusion scan or diffusion-weighted MRI.

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12
Q

What are 3 contraindications for thrombolysis in ischaemic stroke?

A

Previous intracranial haemorrhage

Uncontrolled hypertension

Pregnant

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13
Q

What are 3 contraindications for thrombolysis in ischaemic stroke?

A

Previous intracranial haemorrhage

Uncontrolled hypertension

Pregnant

  • Previous intracranial haemorrhage
  • Seizure at onset of stroke
  • Intracranial neoplasm
  • Suspected subarachnoid haemorrhage
  • Stroke or traumatic brain injury in preceding 3 months
  • Lumbar puncture in preceding 7 days
  • Gastrointestinal haemorrhage in preceding 3 weeks
  • Active bleeding
  • Pregnancy
  • Oesophageal varices
  • Uncontrolled hypertension >200/120mmHg
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14
Q

What is the immediate management for TIA?

A

Aspirin 300mg

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15
Q

What is the pharmacological management for secondary prevention of ischaemic stroke?

A

Clopidogrel

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16
Q

What is the pharmacological management for secondary prevention of ischaemic stroke when the first-line is contraindicated?

A

Aspirin + modified-release dipyridamole

17
Q

When may carotid endarterectomy be offered?

A

Stenosis > 70%

Stroke/TIA not severely disabled patient

18
Q

Under the Oxford classification of stroke, what arteries are affected, and what criteria must be present for a Total anterior circulation infarct (TACI)

A

All of the following:

  1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
19
Q

Under the Oxford classification of stroke, what arteries are affected, and what criteria must be present for a Partial anterior circulation infarct (PACI)

A

2 of the following:

  1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
20
Q

Under the Oxford classification of stroke, what arteries are affected, and what criteria must be present for a lacunar infarct?

A

1 of the following:

  1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
  2. pure sensory stroke.
  3. ataxic hemiparesis
21
Q

Under the Oxford classification of stroke, what arteries are affected, and what criteria must be present for a Posterior circulation infarct (POCI)?

A

1 of the following:

  1. cerebellar or brainstem syndromes
  2. loss of consciousness
  3. isolated homonymous hemianopia
22
Q

What vessel has been affected with a stroke that presents as follows:

Ipsilateral facial pain and temperature loss
Contralateral limb/torso pain and temperature loss
Ataxia
Nystagmus?

What are 2 other names for this type of stroke?

A

Posterior inferior cerebellar artery

23
Q

What vessel is affected in the following stroke:

Ipsilateral facial paralysis, pain, deafness and temperature loss
Contralateral limb/torso pain and temperature loss
Ataxia
Nystagmus?

A

Anterior inferior cerebellar artery

24
Q

What arteries are affected in a Total anterior circulation infarct (TACI)?

A

Middle and anterior cerebral arteries

25
Q

What arteries are affected in a Partial anterior circulation infarct (PACI)?

A

Smaller divisions of the middle cerebral artery or anterior cerebral artery.

26
Q

What arteries are affected in a lacunar infarct?

A

Deep arteries of the internal capsule, thalamus and basal ganglia.

27
Q

What arteries are affected in a Posterior circulation infarct (POCI)?

A

Vertebrobasilar arteries

28
Q

What are 2 alternative names for a posterior inferior cerebellar artery stroke?

A

Lateral medullary syndrome

Wallenberg syndrome

29
Q

What is another name for anterior inferior cerebellar artery stroke?

A

Lateral pontine syndrome

Neuro (4 decks)

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