Stroke Flashcards
What are the types of stroke
Ischaemic stroke
Transient ischaemic attack
Haemorrhagic stroke
What is an ischemic stroke
Vessel occlusion affecting oxygen supply to brain
What is a Transient ischaemic attack
Only lasts a few minutes / hours, acute loss of cerebral function
Vessel occlusion affecting supply of oxygen to brain
What is a Haemorrhagic stroke
When blood vessel bleeds into deep cerebral tissue of brain (intracerebral)
Subarachnoid haemorrhage - blood vessel on surface of brain ruptures and bleeds in space surrounding the brain
How does atrial fibrillation cause stroke/ atherosclerosis?
Turbulent flow and blood stasis in heart increases risk of emboli formation
What is the difference between arterial thrombosis and arterial embolism for ischaemic stroke?
arterial thrombosis -blood clot forms in artery that supplies brain with oxygen
arterial embolism -blood clot forms at a site away from brain
What is a ischaemic penumbra
areas still somewhat alive
Why is a TIA different to an infarction
Autolysis means quick resolution
What are symptoms of an ischaemic stroke
Seizure in haemorrhagic stroke
Weakness
facial droop
ataxia and aphasia
What are the tests for stroke
ASSUME NBM until SALT assessment
Brain imaging
Blood glucose
INR (clotting)
ECG
Fasting lipids
FBC
What is the treatment for TIA
Aspirin 300mg od
What is the treatment for Confirmed TIA or Minor stroke
Dual antiplatelet therapy (and PPI)
* clopidogrel
What is the treatment for Confirmed TIA or Minor stroke WITH AF
Anticoagulant if no CI
Secondary prevention -atorv 80mg
What is the treatment for Ischaemic Stroke
Thrombolysis- alteplase
BP needs to be reduced to 185/110mmHg before treatment
Antiplatelet after 24hrs after thrombolysis
What is the treatment for disabling acute stroke
Aspirin 300mg for up to 2 weeks
If thrombolysed -> 24 hrs after alteplase
At 2 week point
No AF= long term treatment started at discharge
AF= anticoag inform of DOAC or vit.K antagonist
