Stroke Flashcards
What are the two main types?
Ischaemic
Haemorrhagic
What are causes of ischaemic strokes?
- Thrombus/embolus
- Atherosclerosis
- Shock
- Vasculitis
What is a TIA?
Temporary neurological dysfunction lasting less than 24 hours caused by ischaemia without infarction
What are crescendo TIAs?
2 or more TIAs within a week
What is the FAST tool?
Face
Arm
Speech
Time - to call 999
What is the management of TIA presenting within 7 days of onset?
Aspirin 300mg OD
Referral for specialist assessment within 24 hours if within 7 days os symptoms
Diffusion weighted MRI scan
What is management of stroke?
Exclude hypoglycaemia
Immediate non contrast CT head
Aspirin 300mg OD
Consider thrombolysis with alteplase once haemorrhage excluded
What time frame can alteplase be given?
within 4 and a half hours of symptom onset
When is thrombectomy considered?
Offer within 6 hours of symptom onset with IV thrombolysis with confirmed blockage of the proximal anterior circulation
or
Offer within 6-24 hours and proximal posterior circulation
or
Offer within 24 hours with IV thrombolysis and proximal posterior circulation
What investigations should patients have after a stroke or TIA?
Carotid imaging
ECG
What are the top risk factors for stroke?
AF
Carotid artery stenosis
What is involved in secondary prevention
Clopidogrel 75mg OD
Atorvastatin 20-80mg started after 48 hours
BP and diabetes control
Addressing modifiable RFs
How do lacunar infarcts present?
Purely motor sx or
Purely sensory sx
Sensorimotor
Ataxic hemiparesis - ipsilateral weakness and limb ataxia
Clumsy hands
When can a patient start driving following a single TIA? Do they need to inform DVLA?
after 1 month if symptom free
Dont need to inform DVLA
When can a patient start driving if they have had multiple TIAs over a short period of time? Do they need to involve the DVLA?
3 months
Yes
