Stroke Flashcards
What are the different types of Stroke?
- Ischaemic (85%)
- Haemorrhagic (15%)
What is the urgent management of a suspected stroke?
Urgent non-contrast CT to distinguish between an Ischaemic stroke and a Haemorrhagic stroke.
What is the Ischaemic Penumbra?
It describes the cerebral area surrounding the ischaemic event where there is ischaemia without necrosis. This areas is amenable to recovery with thrombolysis.
What causes the majority of Ischaemic strokes?
50% due to Large Vessel Atherosclerosis e.g. Carotid Artery Stenosis.
Causing a Thrombus and then Emboli to get stuck in a smaller cerebral Artery.
What are other causes of Ischaemic stroke?
25% cause by intracranial small vessel Atherosclerosis.
20% are Cardio-Embolic, e.g. in AF there is a thrombus formed in the LA and subsequent embolisation to the brain.
Rare causes include Primary Vascular causes (vasculitis and Atrial dissection)
How does a Haemorrhagic stroke occur?
Occurs when there is rupture of a cerebrospinal artery.
What is the Stroke Classification called?
Bamford/Oxford Classification
What is a TACI defined by?
- Contralateral Hemiplegia or Hemiparesis, AND
- Contralateral Homonymous Hemianopia, AND
- Higher cerebral dysfunction (e.g. aphasia, neglect)
Which Vessels Does a TACI Involve?
The Anterior AND middle Cerebral Arteries on the affected side.
What is a Partial Anterior Circulation Infarct defined by?
2 of Contralateral hemiplegia or hemiparesis,
Contralateral homonymous hemianopia,
Higher cerebral dysfunction (e.g. aphasia, neglect)
OR
Higher Cerebral Infarct Alone
What Vessels could be involved in a PACI?
The Anterior OR Middle cerebral Cerebral Artery on the affected side.
What is A Lacunar Infarct (LACI) defined by?
A pure motor stroke,
Pure sensory stroke,
Sensorimotor stroke,
Ataxic Hemiparesis,
Or Dysarthria-Clumsy Hands syndrome.
Which Vessels are affected by a LACI?
Affects the small deep perforating arteries, typically supplying the internal capsule or thalamus.
What defines a Posterior Circulation Infarct (POCI)?
- Cerebellar Dysfunction, OR
- Conjugated eye movement disorder, OR
- Bilateral motor/Sensory deficit, OR
- Ipsilateral Cranial Nerve Palsy with Contralateral motor/sensory deficit, OR
- Cortical Blindness/Isolated Hemianopia.
What vessels are involved in a POCI?
The Vertebrobasilar Arteries and Associated branches (supplying the cerebellum, Brainstem, and Occipital Lobe)