[stroke]

Answer 1

Endocarditis
AF
MI
Prosthetic valves

Question 2

[stroke]: Where in the brain does a ‘watershed/boundary zone’ stroke occur (not a brain area )

Answer 2

Infarct in the area between the supply of two arteries (i.e. decreased blood supply).

Question 3

[stroke]: When does a ‘watershed/boundary zone’ stroke occur

Answer 3

Sharp drop in BP (sepsis)

Answer 4

CADASIL

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy)

+ rare inherited disorder
+ thickening of the walls of small- and medium-sized blood vessels blocks the flow of blood to the brain

Answer 5

Cerebral autosomal dominant arteriopathy with subcortical infarcts & leucoencephalopthy

Answer 6

NOTCH3

Answer 7

Carotid artery

Answer 8

Carotid bruit
high homocysteine
Syphilis
increased clotting

Answer 9

Lacunar
Brainstem

Answer 10

Basal ganglia
internal capsule
Thalamus
Pons

Answer 11

Consciousness/cognition is unaffected

Answer 12

Brainstem

Answer 13

Brainstem

Answer 14

ABBC TNA

Airway
BP, pulse, ECG
Blood glucose (4-11)
CT/MRI (urgent)
Thrombolysis
NBM
Antiplatelet

Answer 15

Aortic dissection
encephalopathy

Answer 16

4.5 hrs

Answer 17

Alteplase (tissue plasminogen activator)

Answer 18

Major infarct/haemorrhage on CT
Neuro-deficit
recent birth/surgery/trauma/uncompressible puncture
AVM/aneurysm
Previous CNS bleeds
Anticoagulants/
seizures

Answer 19

1.7

Answer 20

> 220/130

Answer 21

<100

Answer 22

post. cerebral

Answer 23

anterior cerebral
middle cerebral

Answer 24

Medial
frontal

Question 25

[stroke]: The medial and frontal cerebral cortices are concerned with contralateral ... and ... (if slightly milder)

Answer 25

leg arm

Question 26

[stroke]: If the legs of a patient are affected but the face is spared which artery is likely to be affected.

Answer 26

Anterior cerebral

Question 27

[stroke]: Akinetic mutism describes a lack of movement and speaking. It can be caused by damage to the cingulate gyrus. .... is the location of the infarct.

Answer 27

Bilateral ant. cerebral artery

Question 28

[stroke]: Contralateral hemiparesis/hemisensory loss, especially of face and arms indicates the ... is infarcted.

Answer 28

Middle cerebral

Question 29

[stroke]: the middle cerebral artery supplies the optic radiation. What might and infarct cause.

Answer 29

Contralateral homonymous hemianopia.

Question 30

[stroke]: Middle cerebral artery infarct on the dominant side of the brain is associated with ...

Answer 30

Dysphasia (disorder of language)

Question 31

[stroke]: Middle cerebral artery infarct on the non-dominant side of the brain is associated with ...

Answer 31

visuo-spatial disorders (gets lost/ cannot dress)

Question 32

[stroke]: Why with a posterior cerebral artery infarct do you get homonymous hemianopia with macular sparing

Answer 32

Macula receives collateral blood supply from the middle cerebral artery.

Question 33

[stroke]: the brainstem is supplied by which arterial system

Answer 33

Vertebro-basilar (i.e. not carotid)

Question 34

[stroke]: Damage to the ventral pons can be casued by infarct of which artery

Answer 34

Pontine

Question 35

[stroke]: infarct of the pontine artery causes ... syndrome due to ischaemia of ventral pons.

Answer 35

Locked in

Question 36

[stroke]: Ischaemia of the lateral medulla and the inferior cerebellum is caused by reduced flow through which 2 arteries

Answer 36

vertebral posterior inferior cerebellar

Question 37

[stroke]: How does lateral medullary syndrome present

Answer 37

vertigo vomiting dysphagia ipsilateral ataxia soft palate paralysis ipsilateral horners analgesia ipsilateral on face, contra on body.

Question 38

[stroke]: What arteries are implicated in lateral medullary syndrome (2)

Answer 38

one vertebral posterior inferior cerebellar

Question 39

[stroke]: If BP differs by >20mmHg in each arm what might you suspect

Answer 39

subclavian artery stenosis

Question 40

[stroke]: If brain ischaemia is related to use of the pts arm which syndrome might be present

Answer 40

Subclavian steal syndrome

Question 41

[stroke]: Retrograde flow of blood down the vertebral artery into arm due to subclavian stenosis is called

Answer 41

Subclavian steal syndrome