Stroke

Question 1

Scoring system

Answer 1

ROSIER

Question 2

Symptoms of anterior cerebral artery stroke

Answer 2

Contralateral hemiparesis and sensory loss,
lower extremity > upper

Question 3

Symptoms of middle cerebral artery stroke

Answer 3

Contralateral hemiparesis and sensory loss,
upper extremity > lower,
Contralateral homonymous hemianopia,
Aphasia

Question 4

Symptoms of posterior cerebral artery stroke

Answer 4

Contralateral homonymous hemianopia with macular sparing,
Visual agnosia

Question 5

Symptoms of Weber’s syndrome (midbrain bit)

Answer 5

Ipsilateral CN III palsy,
Contralateral weakness of upper and lower extremity

Question 6

Symptoms of PICA (Posterior Inferior Cerebellar Artery) AKA Lateral medullary syndrome AKA Wallenburg Syndrome

Answer 6

Ipsilateral: facial pain and temperature loss,
Contralateral: limb/torso pain and temperature loss,
Ataxia,
nystagmus

Question 7

Symptoms of anterior inferior cerebellar artery syndrome AKA Lateral Pontine syndrome

Answer 7

Ipsilateral: facial paralysis and deafness,
Contralateral: limb/torso pain and temperature loss,
Ataxia,
nystagmus

Question 8

Symptoms of central retinal/opthalamic artery occlusion?

Answer 8

Amauroxis fugax

Question 9

Contraindications to thrombolysis

Answer 9

ABC SHIP
Aortic dissection
Bleeding
Coagulation disorders
Stroke <3months ago
Hypertension (severe)
Intracranial neoplasm
Pregnancy

Question 10

Post-Stroke with AF management

Answer 10

edoxaban in Tayside

Question 11

Post-stroke without AF management

Answer 11

Clopidogrel (need anti-platelet cos likely arterial disease)

Question 12

Post-stroke medications long term

Answer 12

2 weeks aspirin, then change to clopidogrel

Question 13

If clopidogrel not tolerated/contraindicated post-stroke, what is long term medication?

Answer 13

aspirin + MR dipyradimole

Question 14

Bamford/Oxford stroke classification of TACI (total anterior circulatory infarcts) - symptoms

Answer 14

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

Question 15

Bamford/Oxford stroke classification of TACI (total anterior circulatory infarcts) - vessels

Answer 15

middle and anterior cerebral arteries occluded

Question 16

Bamford/Oxford stroke classification of PACI (partial anterior circulatory infarcts) - symptoms

Answer 16

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

Question 17

Bamford/Oxford stroke classification of PACI (partial anterior circulatory infarcts) - vessels

Answer 17

smaller arteries of anterior cerebral arteries

Question 18

Bamford/Oxford stroke classification of lacunar infarcts - symptoms

Answer 18

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

Question 19

Bamford/Oxford stroke classification of lacunar infarcts - vessels

Answer 19

perforating arteries around internal capsule/thalamus/basal ganglia

Question 20

Bamford/Oxford stroke classification of POCI (Posterior circulation infarcts) - symptoms

Answer 20

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

Question 21

Bamford/Oxford stroke classification of POCI (Posterior circulation infarcts) - vessels

Answer 21

vertobasilar arteries