Stroke

Question 1

Blood flow to the brain is via the ____ + ___ arteries

Answer 1

internal carotids

vertebral arteries

Question 2

___ and ____ arteries anastamose at the Circle of Willis

Answer 2

Basilar artery + internal carotids

Question 3

Irreversible grey matter cell damage occurs in ____ if hypoxia

Answer 3

3 mins

Question 4

___ stroke is more common than ____

Answer 4

Ischaemic more common than haemorrhagic

Question 5

There is no _____ and little ___ effect on blood flow in the brain

Answer 5

no baroreceptor reflex

little sympathetic effecct

Question 6

Hyperventilation causes fainting as ____

Answer 6

low PCO2 in the brain causes brain arteries to vasoconstrict

Question 7

Active parts of the brain are hyperaemic possibly due to

Answer 7

increased K+ concn due to efflux from active neurons

Question 8

CPP (cerebral perfusion pressure) =

Answer 8

MAP- ICP (intracranial pressure)

Question 9

ICP (intracranial pressure) usually = ___mmHg

Answer 9

8-13mmHg

Question 10

BBB is highly __+___ permeable
___ enters by facilitated diffusion
Impermeable to hydrophilic/phobic molecules

Answer 10

highly O2 and CO2 permeable
glucose by fac diff
impermeable to hydrophilics

Question 11

Strokes show focal/diffuse neuro symptoms = ____ disabilities
This means :

Answer 11

focal = distinct disabilities

can tell which part of brain is affected

Question 12

Haemorrhagic = ___% of strokes

Answer 12

15-20%

Question 13

Biggest risk for stroke of any kind

Answer 13

hbp

Question 14

causes of haemorrhagic stroke

Answer 14

weakened vessel walls due to aneurysm/AVM (arteriovenous malformation)
vasculitis

Question 15

Caused of ischaemic stroke

Answer 15

thrombus, embolus, hypoperfusion

if vessel narrowed then can function if have hbp - if get hypotensive then can get relative ischaemia => stroke

Question 16

Statins are used in ___ stroke

Answer 16

ischaemic

NOT HAEMORRHAGIC

Question 17

Mimics of stroke (5)

Answer 17

hypoglycaemia
seizures
migraine
brain tumours
metabolic problems - hyperglycaemia/hyponatraemia
functional hemiparesis - nerve problem

Question 18

Clinical assessment of stroke depends on:

Answer 18

acute? focal? AF? HF? neuro exam?

Question 19

Most common imaging to distinguish haem from ischaemic stroke

Answer 19

CT +/ angiogram

MRI can show old haemosiderin deposits - old bleed

Question 20

If brain infarcts are bilateral then source of embolism =

Answer 20

cardioembolism
Give ECG (AF) and echocardiogram

Question 21

If brain infarct is unilateral then source of embolism =

Answer 21

atheroembolism - aortic/carotid origin

Do angiogram

Question 22

If stroke in youth then screen for

Answer 22

glucose, lipids, thrombophilia

Question 23

Treatment for ischaemic stroke:

Answer 23

thrombolysis -> aspirin (anti-platelets)
statins and hypertensives prophylactics
anticoagulants if in AF