stroke Flashcards
what is a stroke ?
acute neurological deficit for more than 24 hours
what is the cause of the neurological deficit in a stroke ?
ischaemia to the area supplied by the vessel leading to neurological deficit
what is TIA ?
acute neurological deficit of less than 24 hours withtout acute infarction or tissue injury
what are the 2 types of stroke ?
ischemic stroke or hemorrhagic stroke
what is the difference between an ischemic stroke and a hemorrhagic stroke ?
an ischemic stroke is caused by a blockage whilst hemorrhagic is caused by the rupture of a blood vessel
how can ann ischemic stroke happen ?
either embolic or thrombotic
an embolic stroke occurs when a clot forms somewhere else in the body and gets lodged in a blood vessel in the brain
a thrombotic stroke occurs when the blood clot forms withibn the blood vessels of the btain
what is the normal CBF ?
normal perfusion is 50 ml per 100g per minute
what is the CBF in benign oligemia ?
CBF is > 17 ml per 100g per min
what is the CBF of the penumbra ?
17 to 10 ml per 100g per minute
what is the penumbra ?
tissue around the infarction core than can remain viable for several hours and still salvageable if reperfused
what is the perfusion of the infarct core of an ischemic stroke?
less than 10 ml per 100 g per minute
where does the anterior and posterior circulation arise from ?
the internal carotid artery
what are the segments of the anterior circulation ?
from the anterior cerebral artery arises A1 and A2
from the middle cerebral arteries M1 to M4
what arteries form the posterior circulation ?
from the vertebral arteries which join to form the basiliar artery
where does PICA arise from ?
the distal vertebral arteries
where does the AICA arise from ?
the proximal basilar artery
what are thee differential diagnosis associated with strokes ?
seizures
systemic infection
brain tumors
toxic-metabolic disorders
vertigo
what investigations should be carried out for strokes ?
CT scan to determine whether the stroke is haemorrhagic or ischaemic
MRI
CT angio
MR angio
what are the sclaes used in association with strokes ?
NIHSS
national institutes of health stroke scale
ABCD2
NIHSS vs ABCD2
NIHSS strongly associated with outcome
ABCD2 determine the risk for stroke in the days following TIA
what is the general management approach for ischemic strokes ?
recanalization especially to the penumbra within the first 4 hours and a half with thrombolytic therapy or mechanical thrombectomy
what are the other important aspects of treatment of ischemic stroke ?
supplemental oxygen
glycemic control
optimal blood pressure control
prevention of hyperthermia
