stroke

Question 1

stroke characteristics

Answer 1

rapidly progressive signs and symptoms
focal and global loss of cerebral function
signs and symptoms lasting more than 24hrs

Question 2

2 types of stroke

Answer 2

ischaemic
haemorrhagic

Question 3

is stroke a large r cause of morbidity or mortality

Answer 3

morbidity

Question 4

causes of intracerebral haemorrhage

Answer 4

major - hypertension
trauma
tumour
AV malformation
venous thrombosis
vasculitis
coagulopathy
drugs
infarct

Question 5

ICH complications

Answer 5

local damage
local mass effect
herniation
raised ICP
hydrocephalus
haematoma formation
tissue dissection

Question 6

how can ICH cause hydrocephalus

Answer 6

haematoma compresses ventricles or blood enters ventricles and clogs drainage

Question 7

ICH management

Answer 7

stop aspirin/warfarin
establish cause
treat complications
treat risk factors
rehabilitation

Question 8

surgical treatment of hydrocephalus

Answer 8

VP shunting
CSF diversion
external ventricular drains

Question 9

ischaemic cascade

Answer 9

ischaemia -> Na/K pump failure -> depolarisation -> glutamate release and Ca channel opening -> elevated intracellular Ca -> further depolarisation and cell death

Question 10

how can penumbra be saved

Answer 10

reperfusion

Question 11

stroke risk factors

Answer 11

age
male
socioeconomic status
smoking
obesity
inactivity
alcohol
hypertension
hypercholesterolaemia
diabetes
vascular disease
cardiac problems
genetics

Question 12

what medication may patients be put on for life after a stroke as secondary prevention

Answer 12

statins

Question 13

stroke classification systems

Answer 13

oxford bamford classification - by clinical picture
by vascular anatomy
TOAST classification - by aetiology

Question 14

why can a stroke affecting a small area in the internal capsule affect a wide range of movement

Answer 14

motor tracts bundled together

Question 15

what type of stroke is common in the internal capsule

Answer 15

lacuna stroke

Question 16

anterior circulation stroke signs and symptoms

Answer 16

unilateral motor deficit
homonymous hemianopia
higher cerebral dysfunction - dysphasia/neglect

Question 17

posterior circulation stroke signs and symptoms

Answer 17

pure hemianopia
cerebellar signs
diplopia
CN palsy

Question 18

lacunar stroke signs and symptoms

Answer 18

variable - can be pure motor, pure sensory, sensorimotor, or ataxic hemiparesis

Question 19

ataxic hemipsaresis

Answer 19

clinical syndrome with weakness and ataxia on the same side

Question 20

what is the most common clinical presentation of lacunar stroke

Answer 20

pure motor

Question 21

stroke investigations

Answer 21

CT
MRI
blood tests
carotid doppler
ECG
ECHO

Question 22

additional stroke investigations for patients under 50

Answer 22

vasculitis screen
HIV test
drug screen
thrombophilia screen
lumbar puncture
cECHO

Question 23

stroke treatment

Answer 23

thrombolysis
transfer to stroke unit
review antiplatelet therapy
treat risk factors
treat complications
rehabilitation

Question 24

how does thrombolysis effect mortality

Answer 24

no effect

Question 25

main risk of thrombolysis

Answer 25

haemmorhage

Question 26

antiplatelet drugs

Answer 26

aspirin
dypiridamole
clopidogrel

Question 27

TIA

Answer 27

transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction

Question 28

TIA management

Answer 28

TIA clinic referral
aspirin
CT
ECG
antiplatelets
doppler
anticoagulation
surgery

Question 29

crescendo TIA

Answer 29

multiple recurrent episodes of TIA over hours to days