Stroke Flashcards
Define stroke.
A neurological deficit of sudden onset, lasting more than 24 hours and of vascular origin.
Can a stroke last less than 24 hours?
No, this would be a TIA.
What are the symptoms of stroke?
Loss of power Loss of sensation Loss of speech Loss of vision Loss of co-ordination
–> Stroke symptoms are loss of function
What would likely be found on examination/taking a neurological history?
Motor: clumsy or weak
Sensory: loss of feeling
Speech: dysartrhia or dysphagia
Vision problems
What is a stroke?
Ischaemic: damage to part of the brain due to blockage of a blood vessel by a thrombus or embolus –> 85%
Haemorrhagic: damage to part of the brain by rupture of a blood vessel –> 15%
Also, disease of vessel wall and disturbance of normal properties of blood.
Which vessels supply the brain?
4 vessels go to the brain - 2 vertebral arteries and 2 common carotid arteries. 2 vertebral arteries join to form the basilar artery –> divide to form 2 posterior cerebral arteries. 2 common carotid become internal carotid then middle cerebral –> this is the most common place for a clot to lodge.
If a patient is unable to speak, which part of the brain is probably involved?
Large part as speech is spread across the brain –> this is more serious.
Define homunculus.
A physical representation of the human body located within the brain.
What would happen if a stroke occurs in deep white matter?
Major deficit as fibres are packed close together.
What are the different types of ischaemic stroke?
Clot stops blood supply to an area of the brain.
- Large artery atherosclerosis - carotid stenosis (most common)
- Cardioembolic (due to AF, worse than other types)
- Small artery occlusion
- Arterial dissection
What are the different types of haemorrhagic stroke?
Primary intercerebral haemorrhage –> 70%.
Secondary haemorrhage –> 30% (subarachnoid)
What are the 4 stroke subtypes?
1) TACS: total anterior circulation (20%); higher cerebral dysfunction; weakness; sensory deficit; homonymous hemianopia; large strokes; 6% mortality and recurrence at 1 year
2) PACS: partial anterior circulation (35%); 2/3 of TACS criteria or restricted motor/sensory deficit; more restricted cortical infarcts; 16% mortality at 1 year and 17% recurrence
3) LACS: lacunar (20%); silent and underdiagnosed; pure motor; pure sensory; or combination; ataxia hemiparesis (weakness more prominent in leg than arm); 11% mortality and 9% recurrence
4) POCS: posterior circulation (25%); affect brainstem, cerebellar or occipital lobes; complex presentation; 19% mortality 1 year and 20% recurrence
What is homonymous hemianopia?
Loss of part of the field of view on the same side in both eyes - due to left cerebrovascular events (STROKE).
What are modifiable risk factors for stroke?
AF and HT
What are non-modifiable risk factors for stroke?
Age, race and FH.
