Stroke Flashcards
State 3 causes of an ischemic stroke
- Embolism
- Systemic hypoperfusion
- Thrombosis - poor architecture of blood vessel walls
State 4 causes of hemorrhage stroke
Hypertension
Aneurysms
Ischemic stroke
AV malformations
State the cerebral blood flow that cause infarction and ischemia
Ischemia: <20ml/100g
Infarction: <16 -18ml/100g
Pathogenesis of ischemic stroke
Loss of blood supply
Infarction or necrosis >
1. Swelling of the brain
2. Cytotoxic and vasogenic edema> swelling of the brain
Modifiable very high risk factors of stroke x4
Hypertension
Atrial fibrillation
Previous TIA or stroke
Use of elicit drugs
Ischemic heart disease (high risk)
Questions to ask in history x5
Past trauma
HIV status
Screen for stroke mimic
Exposure to major risk factors
Hypercoagulable diseases - SCD, polycythemia
Describe the function of Siriraj score and state it
Differentiates between hemorrhage or infarction
(2.5xLOC) + (2x vomiting) + (2x headache) + (0.1 x Diastolic BP) + (3xatheroma markers) -12
If < 1= infarction, >1= hemorrhage
Purpose of NIHSS National institute of health stroke scale x4
Predicts patient outcomes
Measures severity of stroke
Finds disabling neurological deficits
Helps determines appropriate treatment
Gold standard investigation for stroke
Angiography
Management objective in stroke x5
Improve circulation
Minimize irreversible brain damage
Prevent complications
Reduce risk of recurrence
Rehabilitation
When in permissive hypertension avoided x3
Intracranial hemorrhage
Recanalization therapy
Subarachnoid hemorrhage
Acute complications of stroke x5
Aspiration pneumonia
Pulmonary embolism
Pressure sores
DVT, UTI
Chronic complications of stroke x5
Depression
Dementia
Pain
Spasticity
Contractures
Late onset seizure
Causes of stroke mimics x7
Hepatic encephalopathy
Uremic encephalopathy
Subdural hematoma
Hyponatremia
Brain atrophy
Brain abscess
Sepsis
