stroke Flashcards

1
Q

what is a stroke ?

A

acute neurological deficit for more than 24 hours

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2
Q

what is the cause of the neurological deficit in a stroke ?

A

ischaemia to the area supplied by the vessel leading to neurological deficit

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3
Q

what is TIA ?

A

acute neurological deficit of less than 24 hours withtout acute infarction or tissue injury

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4
Q

what are the 2 types of stroke ?

A

ischemic stroke or hemorrhagic stroke

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5
Q

what is the difference between an ischemic stroke and a hemorrhagic stroke ?

A

an ischemic stroke is caused by a blockage whilst hemorrhagic is caused by the rupture of a blood vessel

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6
Q

how can ann ischemic stroke happen ?

A

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

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7
Q

what is the normal CBF ?

A

normal perfusion is 50 ml per 100g per minute

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8
Q

what is the CBF in benign oligemia ?

A

CBF is > 17 ml per 100g per min

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9
Q

what is the CBF of the penumbra ?

A

17 to 10 ml per 100g per minute

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10
Q

what is the penumbra ?

A

tissue around the infarction core than can remain viable for several hours and still salvageable if reperfused

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11
Q

what is the perfusion of the infarct core of an ischemic stroke?

A

less than 10 ml per 100 g per minute

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12
Q

where does the anterior and posterior circulation arise from ?

A

the internal carotid artery

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13
Q

what are the segments of the anterior circulation ?

A

from the anterior cerebral artery arises A1 and A2
from the middle cerebral arteries M1 to M4

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14
Q

what arteries form the posterior circulation ?

A

from the vertebral arteries which join to form the basiliar artery

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15
Q

where does PICA arise from ?

A

the distal vertebral arteries

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16
Q

where does the AICA arise from ?

A

the proximal basilar artery

17
Q

what are thee differential diagnosis associated with strokes ?

A

seizures
systemic infection
brain tumors
toxic-metabolic disorders
vertigo

18
Q

what investigations should be carried out for strokes ?

A

CT scan to determine whether the stroke is haemorrhagic or ischaemic
MRI
CT angio
MR angio

19
Q

what are the sclaes used in association with strokes ?

A

NIHSS
national institutes of health stroke scale
ABCD2

20
Q

NIHSS vs ABCD2

A

NIHSS strongly associated with outcome
ABCD2 determine the risk for stroke in the days following TIA

21
Q

what is the general management approach for ischemic strokes ?

A

recanalization especially to the penumbra within the first 4 hours and a half with thrombolytic therapy or mechanical thrombectomy

22
Q

what are the other important aspects of treatment of ischemic stroke ?

A

supplemental oxygen
glycemic control
optimal blood pressure control
prevention of hyperthermia