Stroke Flashcards
What are the 2 main types of strokes
ischaemic -85%
haemorrhagic-15%
What are the subtypes of ischaemic stroke
blockage in blood vessel stops blood flow
-Thrombotic stroke
thrombosis from large vessels
-Embolic stroke
usually a blood clot but can be fat, air, clumps of bacteria
What are the risk factors for ischaemic stroke
age
hypertension
smoking
hyperlipidaemia
diabetes mellitus
AF
What are the subtypes of haemorrhagic strokes
Intracerebral - bleeding within the brain
Subarachnoid- bleeding on surface of brain
What are risk factors of haemorrhagic srokes
age
hypertension
arteriovenous malformation
anticoagulation therapy
What are some general symptoms of stroke
motor weakness
speech problems
swallowing problems
visual field defects
balance problems
What symptoms may a patient with a cerebral hemisphere infarcts have
contralateral hemiplagia
contralateral sensory loss
homonymous hemianopia
dysphagia
What may someone with a brainstem infarction have
more severe symptoms
quadriplegia
lock in syndrome
If the lesion is in the ACA- what symptoms may someone have
contralateral hemiparesis and sensory loss
lower extremity > upper
If the lesion is in MCA what may someone present with
contralateral hemiparesis and sensory loss
upper extremity > lower extremity
contralateral homonymous hemianopia
aphasia
Lesion in PCA- symptoms?
Contralateral homonymous hemianopia with macular sparing
Visual agnosia
What is webers syndrome
branches of PCA that supply midbrain
Ipsilateral CNIII palsy
contralateral weakness of upper and lower extremity
Lesion to posterior inferior cerebellar artery -
( Wallenberg syndrom )
symptoms?
Ipsilateral - facial pain and temp loss
Contralateral - limb/torso pain and temp loss
Ataxia
Nystagmus
Lesion to anterior inferior cerebellar artery
Ipsilateral- facial paralysis and deafness, facial pain and temp loss
Contralateral - limb/torso pain
Lesion to retinal/opthalmic artery - symptoms ?
Amaurosis fugax- temporary loss of vision in one eye that returns to normal
Lesion to basilar artery- symptoms?
‘Locked-in” syndrome
paralysed except for muscle that control the eys
completely conscious
What is the oxford stroke classification
Following criteria should be assessed-
1. unilateral hemiparesis/hemisesnory loss of face arm and leg
- homonymous hemianopia
- higher cognitive dysfunction – eg dysphagia
What classifies a TACI
total anterior circulation infarct
15% of strokes
involves middle and anterior cerebral arteries
all 3 of oxford stroke classification present
What classifies a PACI
partial anterior circulation infarcts
25%
2 of oxford stroke criteria present
What classifies a lacunar infarct
25%
involves perforating arteries around internal capsule , thalamus and basal ganglia
presents with 1 of following
-unilateral weakness of face,arm , leg or all three
-pure sensory stroke
-ataxic hemiparesis
What classifies a posterior circulation infarct
25%
involves vertebrobasilar arteries
presents with 1 of the followings
- cerebellar or brainstem syndromes
- loss of consciousness
-isolated homonymous hemianopia
What symptoms are patients that have suffered from a hemorrhagic stroke more likely to have
decrease in level of consciousness
headache is more common
nausea and vomiting
seizures in up to 1/4 of patients
What investigations are required
first line NON - CONTRAST CT HEAD SCAN
How do acute ischaemic strokes appear on non-contrast CT head scan
may show areas of low density in grey and white matter of the territory
Hyperdense artery sign - corresponds with responsible arterial clot
