Stroke

Question 1

The aspect of the Circle of Willis

Answer 1

The brain is supplied blood by 2 main arteries: the carotid and the vertebral

• Anterior cerebral artery
• Anterior communicating artery
• Middle cerebral artery
• Posterior cerebral artery
• Basilar artery

Question 2

What does each CoW artery supply

Answer 2

ACA:
Superior/medial surface of the frontal lobe
Anterior parietal lobe

MCA:
Majority of the lateral surface of the cerebrum inc. main motor and sensory
Deep structures, inc. basal ganglia and the internal capsule

PCA:
Occipital
inferior/medial surface of the temporal lobe
Thalamus

Bassilar:
Midbrain 
meddula 
Pons 
Cerrbelum

Question 3

Definition of stroke and TIA

Answer 3

A disruption of blood flow to the brain results in student and long-lasting neurological deficits. STROKE

A disruption of blood flow to the brain results in student and non-lasting neurological deficits <24hours

Question 4

Bamford stroke classification

Answer 4

Total anterior circulatory stroke (Need all 3)

• Unilatrall weakness and or sensory loss to the face, arms and legs
• Homongemous heminopia
• Higher cerebral function deficits

Partial anterior circulatory syndrome (need 2)
- SAME AS TACS

Lacuna stroke

• sensory
• motor
• sensory-motor
• ataxic hemiplegia
• No loff of higher cerebral function

Posterior circulatory stroke (need 1)

• cranial nerve palsy with contralateral weakness and or sensory deficits
• isolated homogenous hemianopia
• cerebral deficits such as ataxia
• bilateral weakness and or sensory deficit
• conjugate eye movement disorder for example horizontal gaze

Question 5

Types of stoke and their treatment

Answer 5

Ischemic (85%) Clot/blockage
Athroma (plaque build up)
Thrombosis
Embolism

Treatment: thrombolysis, thrombectomy

Heamoradgic (15%)
Intacranial
Intacerebral

Treatment: Lower blood pressure, reverse any anticoagulants

Question 6

General stroke signs and symptoms

Answer 6

Hemiplegia 
sensory deficits 
ataxia 
dysphasia 
dysarthria 
reduced memory 
reduced attention 
homogenous hemianopia 
dizziness

Question 7

Motor pathway

Answer 7

Primary motor cortex in the frontal lobe
corticospinal tract descends (80% fibres cross in medulla)
into spinal cord
terminates at the ventral horn to synapse with LMN
Alpha: extrafusal
Gamma: Intrafusal

Question 8

Sensory pathway

Answer 8

Ascending tracts 
Sensory receptors pass information via the peripheral sensory neurons to the ascending tracts 
- Dorsal 
- Spinothalamic
- Spinocerrebelum 
Synapse in the thalamus or visual cortex

Question 9

Tone

Answer 9

Hypotonia: CNS, PNS
Hypertonia: CNS

SEE NOTES PICTURE

Question 10

Sensory symptoms of stroke

Answer 10

Impaired cutaneous sensation
impaired stereognosis
impaired proprioception
Visual deficits

Question 11

Speech symptoms of stroke

Answer 11

Dysarthria

dysphasia

Question 12

Cognitive symptoms of stroke

Answer 12

Dyspraxia 
neglect 
memory issues 
retention 
Problem processing

Question 13

Factors affecting recovery

Answer 13

Age 
Size and location of the stroke 
motivation 
appropriate therapy 
engagement 
environment 
insight 
nutrition