Stroke

Question 1

What is the difference between a stroke and a TIA?

Answer 1

• Stroke - brief episodes shorter than 24 hours with brain injury
• TIA - brief episodes shorter than 24 hours with no brain injury

Question 2

Most strokes tend to be caused by what kind of event? Where in the brain?

Answer 2

• Ischaemic
  
  • Thromboembolic - cortical
  • Lacunar - subcortical

Question 3

What should the investigative trail be in a patient suspected of stroke?

Answer 3

• CT/MRI brain
• BGL (exclude hypoglycaemia)
• U&Es (exclude electrolyte disturbances)
• Cardiac enzymes
• ECG/FBE/coags

Question 4

What are the management principles for a patient presenting with stroke?

Answer 4

• Code stroke and nil by mouth
• Rescue penumbra (ischaemic) or watchful waiting (haemorrhagic)
  
  • Thrombolysis if less than 4.5 hours
• Anticoagulation
• Early mobilisation
• Stroke unit co-location
• Resolution of risk factors