stroke Flashcards
stroke characteristics
rapidly progressive signs and symptoms
focal and global loss of cerebral function
signs and symptoms lasting more than 24hrs
2 types of stroke
ischaemic
haemorrhagic
is stroke a large r cause of morbidity or mortality
morbidity
causes of intracerebral haemorrhage
major - hypertension
trauma
tumour
AV malformation
venous thrombosis
vasculitis
coagulopathy
drugs
infarct
ICH complications
local damage
local mass effect
herniation
raised ICP
hydrocephalus
haematoma formation
tissue dissection
how can ICH cause hydrocephalus
haematoma compresses ventricles or blood enters ventricles and clogs drainage
ICH management
stop aspirin/warfarin
establish cause
treat complications
treat risk factors
rehabilitation
surgical treatment of hydrocephalus
VP shunting
CSF diversion
external ventricular drains
ischaemic cascade
ischaemia -> Na/K pump failure -> depolarisation -> glutamate release and Ca channel opening -> elevated intracellular Ca -> further depolarisation and cell death
how can penumbra be saved
reperfusion
stroke risk factors
age
male
socioeconomic status
smoking
obesity
inactivity
alcohol
hypertension
hypercholesterolaemia
diabetes
vascular disease
cardiac problems
genetics
what medication may patients be put on for life after a stroke as secondary prevention
statins
stroke classification systems
oxford bamford classification - by clinical picture
by vascular anatomy
TOAST classification - by aetiology
why can a stroke affecting a small area in the internal capsule affect a wide range of movement
motor tracts bundled together
what type of stroke is common in the internal capsule
lacuna stroke
anterior circulation stroke signs and symptoms
unilateral motor deficit
homonymous hemianopia
higher cerebral dysfunction - dysphasia/neglect
posterior circulation stroke signs and symptoms
pure hemianopia
cerebellar signs
diplopia
CN palsy
lacunar stroke signs and symptoms
variable - can be pure motor, pure sensory, sensorimotor, or ataxic hemiparesis
ataxic hemipsaresis
clinical syndrome with weakness and ataxia on the same side
what is the most common clinical presentation of lacunar stroke
pure motor
stroke investigations
CT
MRI
blood tests
carotid doppler
ECG
ECHO
additional stroke investigations for patients under 50
vasculitis screen
HIV test
drug screen
thrombophilia screen
lumbar puncture
cECHO
stroke treatment
thrombolysis
transfer to stroke unit
review antiplatelet therapy
treat risk factors
treat complications
rehabilitation
how does thrombolysis effect mortality
no effect
main risk of thrombolysis
haemmorhage
antiplatelet drugs
aspirin
dypiridamole
clopidogrel
TIA
transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction
TIA management
TIA clinic referral
aspirin
CT
ECG
antiplatelets
doppler
anticoagulation
surgery
crescendo TIA
multiple recurrent episodes of TIA over hours to days
