Stroke Flashcards
What is a stroke?
Sudden interruption in the blood supply of the brain.
Why does stroke cause so much damage?
The brain is dependent on aerobic metabolism, so any oxygen supply issue can quickly lead to irreversible damage.
What type of stroke is the most common?
Ischaemic stroke (85%).
What causes an ischaemic stroke?
Blockage in blood vessels, stopping blood flow.
What are the subtypes of ischaemic stroke?
- Thrombotic
- Embolic
- Transient Ischaemic attack (TIA)
What are the main risks for ischaemic stroke?
- Age +
- Hypertension (HTN)
- Smoking
- Diabetes Mellitus (DM)
- Atrial Fibrillation (AF)
- Hyperlipidaemia
What type of stroke is rarer?
Haemorrhagic stroke (15%).
What causes a haemorrhagic stroke?
Blood vessel ‘bursts’, leading to reduction in blood flow.
What are the subtypes of haemorrhagic stroke?
- Intracerebral haemorrhage
- Subarachnoid haemorrhage
What are the main risks for haemorrhagic stroke?
- Age +
- Hypertension (HTN)
- Arteriovenous Malformation (AVM)
- Anticoagulation therapy
What are common symptoms of a stroke?
- Motor weakness
- Speech issues (dysphasia)
- Swallowing problems
- Visual field defects (homonymous hemianopia)
- Balance problems
What are symptoms of cerebral hemisphere infarcts?
- Contralateral hemiplegia
- Contralateral sensory loss
- Homonymous hemianopia
- Dysphagia
What are symptoms of brainstem infarction?
Severe symptoms: Quadriplegia, locked-in syndrome.
What are lucunar infarcts?
Infarcts around basal ganglia, internal capsule, thalamus, and pons.
What results from lucunar infarcts?
- Pure motor
- Pure sensory
- Mixed motor and sensory
- Ataxia (loss of muscle control)
What does the Oxford Stroke Classification classify?
Stroke based on initial symptoms.
What are the classes in the Oxford Stroke Classification?
- Unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
- Homonymous hemianopia
- Higher cognitive dysfunction e.g. dysphasia
What is Lateral Medullary Syndrome also known as?
Wallenberg’s syndrome.
What are the symptoms of Lateral Medullary Syndrome?
- Ipsilateral ataxia
- Ipsilateral nystagmus
- Ipsilateral dysphagia
- Ipsilateral facial numbness
- Ipsilateral cranial nerve palsy (Horner’s)
- Contralateral limb sensory loss
What are the symptoms of Weber’s syndrome?
- Ipsilateral III palsy
- Contralateral weakness
Can symptoms help differentiate between haemorrhage and ischaemic stroke?
Alone, the symptoms cannot definitively tell the difference.
What symptoms are more common in haemorrhages?
- Decrease or loss of consciousness (LOC)
- Headache
- Nausea/Vomiting (N/V)
- Seizure
What does the FAST acronym stand for in stroke assessment?
- Face
- Arms
- Speech
- Time (999)
What is the first step in the ROSIER Score?
Exclude hypoglycaemia.
