Stroke - 202 Flashcards
What are the 2 main arteries that supply the circle of Willis?
Internal carotid
Vertebral artery
Branches of what artery supply the brainstem?
The basilar artery
What vein is the collecting point for all venous drainage from the brain?
The internal jugular vein
Which veins join to form the external jugular vein?
Facial vein
Retromandibular vein
How is a venous sinus thrombosis treated? Why?
Anticoagulation. Even though you can have haemorrhage with it, the main cause is a clot which needs to be treated to stop the haemorrhage.
What is a venous sinus thrombosis? Name some symptoms
Presence of a clot in the dural venous sinuses.
Headache, abnormal vision
What is the clinical definition of a stroke? How many are ischemic vs haemorrhagic?
Neurological deficit related to an atraumatic vascular event. 85% ischemic. 15% haemorrhagic.
How is a TIA different from a stroke?
Lasts <24hrs. In reality it is more like 10 minutes.
Name some cardinal features of stroke
- Focal clinical deficits
- Negative clinical phenomenon (loss of function)
- Symptoms relate to arterial anatomy
- Sudden onset
Which arterial infarction is the most common in stroke?
MCA
PICH (primary intracranial haemorrhage) can cause a specific clinical symptom. What is it? What clinical signs can it cause?
Thunderclap headache due to massive increase in intracranial pressure
It can cause the Cushing Reflex (response to increased ICP that causes increased bp, irregular breathing and decreased hr)
How is the demographic different for CVST (cerebral venous sinus thrombosis)?
Young, oral contraceptive pill.
It is very easy to miss.
Name some symptoms of brainstem strokes
Vertigo, ataxia, crossed signs, dysarthria, etc
What are some basic investigations done if a stroke is suspected?
FBC, ESR, lipids, glucose BP ECG CXR Head CT +/- MRI
What is the time period for giving thrombolysis? What other specifications are there?
Must be <3 hrs since ONSET of symptoms
No factors to increase risk of ICH, e.g. high bp
