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CM Clinical Symposia > Stroke (3) > Flashcards

Stroke (3) Flashcards

1
Q

Stroke

A

Sudden onset, focal neurological deficit of vascular origin, symptoms last over 24 hours/death

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2
Q

Sir Godfrey Hounsfield

A

X-ray computed tomography

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3
Q

What percentage of strokes are caused by infarction?

A

85%

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4
Q

What percentage of strokes are caused by haemorrhage?

A

15%

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5
Q

Acute ischaemic stroke

A

Initial reduction in cerebral blood flow > ischaemia > alterations in cellular chemistry > cellular necrosis

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6
Q

Cerebral blood flow

A

50-55ml/100g

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7
Q

Average brain weighs

A

1400g (2% body weight)

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8
Q

Average Cerebral Blood Flow

A

800ml/min (15% cardiac output)

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9
Q

Whole brain oxygen consumption (CMRO2)

A

3.3-3.5ml/100g/min
45ml O2/min
20% total body O2 consumption at rest

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10
Q

Flow =

A

pressure/resistance

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11
Q

CPP

A

Cerebral perfusion pressure

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12
Q

CVR

A

Cerebrovascular resistance

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13
Q

CBV

A

Cerebral blood volume

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14
Q

OEF

A

Oxygen extraction fraction (30% normally)

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15
Q

PaCO2

A

1mmHg rise > 3-5% increase in CBF

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16
Q

Viscosity

A

Normally mainly haematocrit

17
Q

What is the sole substrate for energy metabolism in the cerebrum?

A

Glucose (75-100mg/min or 125g/day)

18
Q

Glucose is metabolised by the … sequence and the … cycle

A

glycolytic sequence and the tricarboxylic acid cycle

19
Q

Neurones require a constant supply of ATP, why?

A

To maintain integrity (K+ inside, Na+ and Ca2+ outside), cannot be stored

20
Q

Glycolysis

A

1M glucose > 2M pyruvate (generates 2M ATP in process)

21
Q

Aerobic

A

Pyruvate > CO2 and H20 + 36 ATP

22
Q

Anaerobic

A

Pyruvate > lactate + 2M ATP

23
Q

What causes ischaemic stroke?

A

Athero-thrombo-embolism
Thrombosis (extra-cranial/intra-cranial)

Embolism (cardiogenic/artery to artery)

Atrial Fibrillation

24
Q

Treatment

A

Thrombolysis, early recanalisation or stentrivers

25
Q

Which vessel occlusion accounts for 18-25% of all ischaemic stroke but 60-70% of deaths/severe disability?

A

Proximal anterior circualtion large vessel occlusion (ICA/M1)

26
Q

Stentrievers

A

Stents reperfuse brain, leave for 10 mins, withdraw stent with smaller clot ‘core’

CM Clinical Symposia (24 decks)

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