stroke Flashcards
main risk factor of intracerebral haemorrhage
htn
what drugs must be stopped in ICH
warfarin/aspirin
risks of lowering blood pressure acutely
AKI, reduced brain perfusion
what do you see here
MCA occlusion. ischaemic stroke at about 3 h
what is the specific name of this type of stroke
lacunar
what is the name of the part of an acute ischaemic stroke that is at risk of progressing to infarction but is still salvageable if reperfused. It is usually located around an infarct core which represents the tissue which has already infarcted or is going to infarct regardless of reperfusion
penumbrA
where in the left atrium is AF the most risk for stroke
left atrial appendage
2 biggest risk areas for stroke
atherosclerosis, arteriolarsclerosis
medicines for lowering LDL
statins
post stroke med for life even if normal blood
statin
why might a patient with a tiny little lacunar stroke have devastating hemiparesis
CS fibres all come together via the internal capsule which can be affected by ischaemia in stroke and wiped out
describe the pyramidal pathway
Primary motor cortex
internal capsule
cerebral peduncles
decussation of pyramidsd
spinal cord
which vessels cause lacunar strokes
perferators such as lenticulostriate
what defines a lacunar stroke, clinically
ABSENCE of cortical signs eg dyspahsia, neglect
also pure motor, pure sensory, ataxic hemiparesis
anterior circulation stroke clinical signs
cerebral/cortical signs eg dysphasia
unliateral motor deficit
homonymous hemianopia
posterior circulation stroke clinical signs
diplopia
cranial nerve signs
cerebellar signs
bilateral motor/sensory signs
very basic difference in management of large vs small vessel stroke
large vessel, look for atherosclerosis partic in carotids
small vessel, screen for risk factors such as diabetes etc
best tx for ischaemic stroke
thrombolysis
best antiplatelet monotherapy
clopidogrel
alternative dual therapy to clopidogrel
aspirin and dipyridamole
what do you do if pt presents with TIA
give 330mg aspirin and refer to TIA clinic asap
carotid imaging within 24h
medical emergency!!
Describe TACS
All three of loss of sensory and or motor to face arm and leg unilateral
Homonymous hemianopia
Upper cerebral functions eg dysphasia
Describe PACS
Two of
Describe LACS
One of
Pure sensory loss
Pure motor loss
Sensorimotor loss
Ataxic hemiparesis
Describe POCS
Describe POCS
