Stroke

Question 1

What is a stroke?

Answer 1

A stroke is a neurological condition caused by a disruption of blood supply to a part of the brain, leading to cell death.

Question 2

What are the two main types of stroke?

Answer 2

Ischaemic stroke and haemorrhagic stroke.

Question 3

What are the common symptoms of a stroke?

Answer 3

Sudden weakness or numbness (especially on one side of the body), facial drooping, speech difficulties, vision problems, dizziness, or loss of balance.

Question 4

What is the acronym FAST used for in stroke recognition?

Answer 4

FAST stands for Face drooping, Arm weakness, Speech difficulties, and Time to call emergency services.

Question 5

What is the aetiology of an ischaemic stroke?

Answer 5

It is caused by a blood clot or embolism obstructing cerebral blood flow, often due to atherosclerosis, atrial fibrillation, or other embolic sources.

Question 6

What is the aetiology of a haemorrhagic stroke?

Answer 6

It is caused by bleeding into the brain tissue or surrounding spaces, often due to hypertension, trauma, or aneurysmal rupture.

Question 7

What is the prevalence of stroke in the UK?

Answer 7

Stroke is a leading cause of disability and death in the UK, with approximately 100,000 strokes occurring annually.

Question 8

What are the main risk factors for stroke?

Answer 8

Hypertension, diabetes, smoking, atrial fibrillation, hyperlipidaemia, obesity, physical inactivity, and excessive alcohol consumption.

Question 9

What is the pathophysiology of an ischaemic stroke?

Answer 9

It involves a reduction in cerebral blood flow leading to oxygen deprivation, cell death, and brain tissue damage.

Question 10

What is the pathophysiology of a haemorrhagic stroke?

Answer 10

It involves the rupture of a blood vessel causing bleeding, increased intracranial pressure, and secondary tissue damage.

Question 11

What clinical examination findings might indicate a stroke?

Answer 11

Weakness or sensory loss on one side of the body, facial asymmetry, slurred speech, gaze deviation, and signs of neglect.

Question 12

What is the initial imaging investigation for suspected stroke?

Answer 12

A non-contrast CT head scan to differentiate between ischaemic and haemorrhagic stroke.

Question 13

What is the role of MRI in stroke diagnosis?

Answer 13

MRI, particularly diffusion-weighted imaging (DWI), is more sensitive in detecting acute ischaemic changes.

Question 14

What are some blood tests performed for stroke evaluation?

Answer 14

Full blood count, coagulation profile, blood glucose, lipid profile, and renal function tests.

Question 15

What is the differential diagnosis for stroke?

Answer 15

Hypoglycaemia, seizures, migraines, brain tumours, or Bell’s palsy.

Question 16

What is the acute management for ischaemic stroke?

Answer 16

Thrombolysis with alteplase within 4.5 hours of onset or thrombectomy in suitable cases.

Question 17

What is the acute management for haemorrhagic stroke?

Answer 17

Blood pressure control, reversal of anticoagulation, and neurosurgical intervention in some cases.

Question 18

What conservative measures can help reduce stroke risk?

Answer 18

Lifestyle changes such as smoking cessation, regular exercise, a healthy diet, and weight management.

Question 19

What medical treatments are used in stroke prevention?

Answer 19

Antiplatelet therapy (aspirin or clopidogrel), anticoagulation (if indicated), and antihypertensive and lipid-lowering medications.

Question 20

What surgical options are available for stroke management?

Answer 20

Carotid endarterectomy for significant carotid artery stenosis and surgical intervention for haemorrhagic strokes in certain cases.

Question 21

What is transient ischaemic attack (TIA)?

Answer 21

TIA is a temporary disruption of blood flow to the brain, causing stroke-like symptoms that resolve within 24 hours without permanent damage.

Question 22

Why is TIA significant in stroke care?

Answer 22

It is a warning sign of a potential future stroke and requires urgent assessment and management.

Question 23

What role does rehabilitation play in stroke management?

Answer 23

Rehabilitation focuses on physical therapy, occupational therapy, and speech therapy to help recover lost functions and improve quality of life.

Question 24

What are the potential long-term complications of a stroke?

Answer 24

Paralysis, cognitive impairment, aphasia, depression, and increased risk of future strokes.