Stroke Flashcards
What is the definition of a stroke?
Stroke is a rapidly developing clinical sign of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.
What are the two major types of stroke?
The two major types are ischemic stroke and hemorrhagic stroke.
What is a transient ischemic attack (TIA)?
A TIA is a temporary episode of focal dysfunction of vascular origin, commonly lasting 2-15 minutes, but sometimes up to 24 hours, with no persistent neurological deficit.
What are the subtypes of hemorrhagic stroke?
Intracerebral hemorrhage and subarachnoid hemorrhage.
What is the most common cause of ischemic stroke?
Thromboembolism due to atherosclerosis or atrial fibrillation.
What are the major risk factors for stroke?
Hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, atrial fibrillation, and sedentary lifestyle.
What is the pathophysiology of ischemic stroke?
Occurs due to vascular occlusion leading to an infarct, with the ischemic core and salvageable penumbra.
What are the two major mechanisms of ischemic stroke?
Thromboembolism and hemodynamic failure.
What is the pathophysiology of intracerebral hemorrhage (ICH)?
Usually caused by rupture of small arteries weakened by chronic hypertension, leading to bleeding in the brain parenchyma.
What is the most common cause of intracerebral hemorrhage?
Chronic hypertension causing small artery rupture.
What are common clinical presentations of anterior cerebral artery (ACA) stroke?
Contralateral motor weakness (leg > arm/face), sensory disturbance, dysarthria, aphasia, and urinary incontinence.
What are common clinical presentations of middle cerebral artery (MCA) stroke?
Contralateral weakness (face & arm > leg), aphasia (if left-sided), and sensory neglect (if right-sided).
What are common clinical presentations of posterior cerebral artery (PCA) stroke?
Homonymous hemianopia and motor deficits.
What are lacunar strokes?
Small vessel strokes affecting the subcortex, brainstem, or cerebellum, often due to hypertension or diabetes mellitus.
What are the five classic lacunar stroke syndromes?
Pure motor, pure sensory, sensorimotor, ataxic hemiparesis, and dysarthria-clumsy hand syndrome.
What is the gold standard imaging for stroke?
Non-contrast CT brain scan.
What is the main goal of acute ischemic stroke (AIS) management?
Achieve timely recanalization, optimize collateral flow, and avoid secondary brain injury.
What is the time window for thrombolysis in AIS?
3-4.5 hours from symptom onset.
What is the first-line medication for AIS patients ineligible for thrombolysis?
Aspirin 300 mg daily.
What are indications for antihypertensive use in AIS?
BP > 220/120 mmHg, hypertensive emergencies, acute pulmonary edema, acute kidney dysfunction, hypertensive encephalopathy, or aortic dissection.
Why should blood pressure not be rapidly lowered in AIS?
Rapid BP reduction can cause reduced cerebral perfusion and worsen ischemia.
What are key management strategies for intracerebral hemorrhage?
Control BP, maintain cerebral perfusion, avoid anticoagulants, and consider neurosurgical interventions if indicated.
What is the most common cause of cardioembolic stroke?
Atrial fibrillation.
What score is used to stratify stroke risk in atrial fibrillation?
CHA2DS2-VASc score.
What is the recommended INR target for stroke prevention in atrial fibrillation?
INR of 2-3.
What is the HAS-BLED score used for?
Assessing bleeding risk in patients with atrial fibrillation on anticoagulation.
What are the most common complications of stroke?
Deep vein thrombosis, pulmonary embolism, infections, pressure ulcers, malnutrition, depression, and recurrent stroke.
What are the most common acute neurological complications of stroke?
Cerebral edema, mass effect, hemorrhagic transformation, seizures, and recurrent stroke.
What are key rehabilitation strategies for stroke?
Physiotherapy, occupational therapy, speech therapy, lifestyle modifications, and secondary prevention.
What is the ABCD2 score used for?
Risk stratification of transient ischemic attacks (TIA).
What are the components of the ABCD2 score?
Age ≥60, BP ≥140/90, Clinical symptoms, Duration, Diabetes.
What is subarachnoid hemorrhage (SAH)?
Bleeding into the subarachnoid space, often due to ruptured aneurysm.
What is the hallmark symptom of SAH?
Sudden severe headache (‘thunderclap headache’).
What are risk factors for SAH?
Hypertension, smoking, heavy alcohol use, female sex, and family history of aneurysm.
What is the first-line imaging for SAH?
Non-contrast CT scan.
What medication is used to prevent vasospasm after SAH?
Nimodipine 60 mg every 4 hours for 21 days.
What is the definitive treatment for aneurysmal SAH?
Neurosurgical clipping or endovascular coiling.
What are complications of SAH?
Rebleeding, vasospasm, hydrocephalus, neurogenic pulmonary edema, and seizures.
What is the primary goal of stroke prevention?
Managing risk factors such as hypertension, diabetes, dyslipidemia, and lifestyle modifications.
What is the definition of a stroke?
Stroke is a rapidly developing clinical sign of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.
What are the two major types of stroke?
The two major types are ischemic stroke and hemorrhagic stroke.
What is a transient ischemic attack (TIA)?
A TIA is a temporary episode of focal dysfunction of vascular origin, commonly lasting 2-15 minutes, but sometimes up to 24 hours, with no persistent neurological deficit.
What are the subtypes of hemorrhagic stroke?
Intracerebral hemorrhage and subarachnoid hemorrhage.
What is the most common cause of ischemic stroke?
Thromboembolism due to atherosclerosis or atrial fibrillation.
What are the major risk factors for stroke?
Hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, atrial fibrillation, and sedentary lifestyle.
What is the pathophysiology of ischemic stroke?
Occurs due to vascular occlusion leading to an infarct, with the ischemic core and salvageable penumbra.
What are the two major mechanisms of ischemic stroke?
Thromboembolism and hemodynamic failure.
What is the pathophysiology of intracerebral hemorrhage (ICH)?
Usually caused by rupture of small arteries weakened by chronic hypertension, leading to bleeding in the brain parenchyma.
What is the most common cause of intracerebral hemorrhage?
Chronic hypertension causing small artery rupture.
What are common clinical presentations of anterior cerebral artery (ACA) stroke?
Contralateral motor weakness (leg > arm/face), sensory disturbance, dysarthria, aphasia, and urinary incontinence.
What are common clinical presentations of middle cerebral artery (MCA) stroke?
Contralateral weakness (face & arm > leg), aphasia (if left-sided), and sensory neglect (if right-sided).
What are common clinical presentations of posterior cerebral artery (PCA) stroke?
Homonymous hemianopia and motor deficits.
What are lacunar strokes?
Small vessel strokes affecting the subcortex, brainstem, or cerebellum, often due to hypertension or diabetes mellitus.
What are the five classic lacunar stroke syndromes?
Pure motor, pure sensory, sensorimotor, ataxic hemiparesis, and dysarthria-clumsy hand syndrome.
What is the gold standard imaging for stroke?
Non-contrast CT brain scan.
What is the main goal of acute ischemic stroke (AIS) management?
Achieve timely recanalization, optimize collateral flow, and avoid secondary brain injury.
What is the time window for thrombolysis in AIS?
3-4.5 hours from symptom onset.
What is the first-line medication for AIS patients ineligible for thrombolysis?
Aspirin 300 mg daily.
What are indications for antihypertensive use in AIS?
BP > 220/120 mmHg, hypertensive emergencies, acute pulmonary edema, acute kidney dysfunction, hypertensive encephalopathy, or aortic dissection.
Why should blood pressure not be rapidly lowered in AIS?
Rapid BP reduction can cause reduced cerebral perfusion and worsen ischemia.
What are key management strategies for intracerebral hemorrhage?
Control BP, maintain cerebral perfusion, avoid anticoagulants, and consider neurosurgical interventions if indicated.
What is the most common cause of cardioembolic stroke?
Atrial fibrillation.
What score is used to stratify stroke risk in atrial fibrillation?
CHA2DS2-VASc score.
What is the recommended INR target for stroke prevention in atrial fibrillation?
INR of 2-3.
What is the HAS-BLED score used for?
Assessing bleeding risk in patients with atrial fibrillation on anticoagulation.
What are the most common complications of stroke?
Deep vein thrombosis, pulmonary embolism, infections, pressure ulcers, malnutrition, depression, and recurrent stroke.
What are the most common acute neurological complications of stroke?
Cerebral edema, mass effect, hemorrhagic transformation, seizures, and recurrent stroke.
What are key rehabilitation strategies for stroke?
Physiotherapy, occupational therapy, speech therapy, lifestyle modifications, and secondary prevention.
What is the ABCD2 score used for?
Risk stratification of transient ischemic attacks (TIA).
What are the components of the ABCD2 score?
Age ≥60, BP ≥140/90, Clinical symptoms, Duration, Diabetes.
What is subarachnoid hemorrhage (SAH)?
Bleeding into the subarachnoid space, often due to ruptured aneurysm.
What is the hallmark symptom of SAH?
Sudden severe headache (‘thunderclap headache’).
What are risk factors for SAH?
Hypertension, smoking, heavy alcohol use, female sex, and family history of aneurysm.
What is the first-line imaging for SAH?
Non-contrast CT scan.
What medication is used to prevent vasospasm after SAH?
Nimodipine 60 mg every 4 hours for 21 days.
What is the definitive treatment for aneurysmal SAH?
Neurosurgical clipping or endovascular coiling.
What are complications of SAH?
Rebleeding, vasospasm, hydrocephalus, neurogenic pulmonary edema, and seizures.
What is the primary goal of stroke prevention?
Managing risk factors such as hypertension, diabetes, dyslipidemia, and lifestyle modifications.
