Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Stroke > Flashcards

Stroke Flashcards

1
Q

What are the main cerebrovascular problems?

A

Thromboembolic infarction
Cerebral and cerebellar haemorrhage
Subarachnoid haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common causes of stroke?

A

Ischaemic

  • arterial embolism
  • arterial thrombosis of an atheromatous artery

Haemorrhage into the brain
Venous infarction
Carotid or vertebral artery dissection
Fat or air embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Modifiable risk factors for stroke?

A 
Hypertension
Smoking
Sedentary lifestyle
Excessive alcohol 
Hypercholesterolaemia 
Diabetes
AF
Arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Non-modifiable risk factors of strokes?

A

Age
Gender (male)
Family history
Previous stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the maximum time a TIA can last?

A

24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What normally happens in a TIA?

A

Microemboli form causing temporary ischaemia to the region

Autoregulation of the brain vasculature prevents any infarction developing

Can also be caused by a small intracranial haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Common symptoms of a TIA?

A

Hemiplegia
Aphasia
Loss of vision in one eye
Transient global amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are people who have suffered a TIA more at risk of?

A

Stroke

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the most common occlusion of an artery in a stroke and what does this affect?

A

Middle cerebral artery

Internal capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the common clinical features of a stroke?

A

Contralateral hemiparesis/hemiplegia

Aphasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a TACS and what has been occluded?

A

Total anterior circulation stroke (20%)

A proximal occlusion such as internal carotid or proximal middle cerebral infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the consequence of a TACS?

A

Large volume infarct of superficial and deep territories

High mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical presentation in TACS?

A

Contralateral hemiparesis
Possible hemianaesthesia
Contralateral hemianopia
Higher cerebral dysfunction - cortical signs such as dysphasia and dyspraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a PACS? What is occluded?

A

Partial anterior circulation stroke
Occlusion of middle cerebral artery branch
-causes a restricted infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical presentation of PACS?

A

Restricted motor deficit - face, arm or leg only

Isolated cortical signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a LACS and which arteries are affected?

A

Lacunar stroke

Single perforating artery to basal ganglia or pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clinical presentation of a LACS stroke?

A

Pure motor or pure sensory, sensorimotor, ataxic hemiparesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which vessels does a POCS affect?

A

Posterior circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical presentation of POCS?

A

Brainstem
Cerebellar, brainstem or occipital involvement
Complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common cause of a POCS?

A

Thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which type of stroke is often silent and under-diagnosed?

A

LACS

22
Q

How can location be found out (without doing a CT)

A

Neurological symptoms

  • body parts affected
  • modalities involved
23
Q

What are positive and negative symptoms?

A

Positive - pain, pins and needles

Negative - would indicate stroke: loss of power, speech, sensation

24
Q

What symptoms would suggest a haemorrhagic cause?

A

Haemorrhagic: headache, seizure

25
Q

Differential diagnosis of stroke?

A

Hypoglycaemia, other metabolic disturbance

Migrainous aura

Space occupying lesion

Demyelination

Labyrinthine disorders

26
Q

If the dominant half is affected, what do patients often present with?

A

Dysphagia

Dysgraphia (inability to write coherently)

Dyslexia

27
Q

If the non-dominant half of the cortex is affected, what do patients tend to present with?

A

Visuospatial disorder

Neglect

28
Q

Investigations to do in suspected stroke?

A 
Head CT
ECG
BM
FBC
INR
29
Q

Criteria for giving thrombolysis after a stroke?

A

Within 4.5 hours of documented onset
Thromboembolic
No bleeding risk (not on warfarin)
Over 18

30
Q

Management of stroke where thrombolysis is not suitable?

A

Aspirin
Management in acute stroke unit
Rehabilitation

31
Q

Secondary prevention for stroke?

A

Long-term anti-hypertensives
Anti-platelets - clopidogrel
Anticoagulants in those with AF

32
Q

What are the two syndromes after an infarct of the brainstem?

A

Lateral medullary syndrome (Wallenberg’s): occlusion of posterior inferior cerebellar artery - vertigo with cerebellar and other signs

Locked-in syndrome

33
Q

What happens in vascular dementia?

Signs?

A

Multiple infarcts causing generalised intellectual loss

Get eventual dementia, pseudobulbar palsy and shuffling gait

34
Q

Common causes of intracerebral haemorrhage?

A

Degeneration of penetrating arteries from rupture of micro-aneurysms - commonly leads to a massive bleed

Deposition of myeloid around cerebral vessels in the elderly

35
Q

Main risk factor for intracerebral haemorrhage?

A

Hypertension

36
Q

Common sites of intracerebral haemorrhage?

A

Basal ganglia
Pons
Cerebellum
Subcortical white matter

37
Q

Common presentation of intracerebral haemorrhage?

A

Dramatic with a severe headache

38
Q

Risk factors for subarachnoid haemorrhage?

A

Male
Hypertension
Atheroma
Other diseases

39
Q

Presentation of subarachnoid haemorrhage at the base of the brain?

A 
Thunderclap headache 
Sentinel headache 
Loss of consciousness
Often instantly fatal 
Arterial spasm causes ischaemia and infarction
40
Q

Management of a haemorrhagic stroke?

A

Possible neurosurgery to remove a clot

Anti-hypertensives

41
Q

Prognosis of haemorrhagic stroke?

A

Poor

42
Q

Blood supply to the spinal cord?

A

Single anterior spinal artery (supplies anterior 2/3rds, motor) - artery of Adamkiewicz reinforces it in thoracolumbar area

Paired posterior spinal cord arteries - posterior columns

43
Q

What are spinal artery infarcts normally caused by?

A

Intrinsic spinal vessel disease

  • SLE
  • arteritis
  • atherosclerosis

Aortic disease

  • aneurysm
  • trauma
  • dissection
  • atherosclerosis
Aortic surgery
Sickle cell disease
Hypertension 
Cardiac emboli 
Tumours compressing on spinal cord 
Decompression sickness
Disc herniation
44
Q

Presentation of ischaemic spinal vessel disease?

A

Acute
Very painful

Fever - red flag, suggests

  • bacterial meningitis
  • epidural/subdural abscess
  • granuloma
  • viral illness
45
Q

Differential diagnosis of ischaemic spinal disease?

A

Mass lesion eg tumour, granuloma, haematoma, herniated disc

Intraspinal haemorrhage

Acute inflammatory demyelinating polyneuropathy eg Guillaim-Barré syndrome

Sarcoidosis, TB, syphilis

46
Q

Management of ischaemic spinal artery disease?

A

Identify and treat underlying cause
Manage vascular risk factors

Prognosis normally poor

47
Q

What is the pathology behind the decorticate response?

A

Connections between thalamus and cortex are lost, isolating the cortex from the lower brain and spinal cord

48
Q

What does the decorticate response look like?

A

Lower limbs extended and upper limbs are flexed

49
Q

What is the pathology behind the decerebrate response?

A

Damage to lower parts of the brain or brainstem leads to complete loss of descending inhibition on descending motor tracts

50
Q

What does the decerebrate response look like?

A

Complete extension of upper and lower limbs and head

Neurology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions