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Cardiovascular system > Stroke > Flashcards

Stroke Flashcards

1
Q

hoe long must a stroke last to be defined as stroke?

A

more that 24 hours

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2
Q

give some general symptoms of stroke

A 
> loss of power
> loss of sensation
> loss of speech
> loss of vision
> loss of coordination
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3
Q

what is gaze palsy?

A

double vision horizontally

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4
Q

what causes damage to part of the brain during a stroke?

A

blockage of blood vessel by a thrombus or embolus, or due to a haemorrhage from a ruptured blood vessel

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5
Q

what does the external carotid artery supply?

A

the face

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6
Q

what is unique about the basilar artery?

A

it is formed from two smaller vessels which join together

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7
Q

what does the vertebral-basilar system supply?

A

the brain stem, cerebellum and occipital lobes with the posterior cerebral artery

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8
Q

what does the internal carotid supply?

A

the hemispheres and cortical deep white matter

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9
Q

what two arteries does the internal carotid split into?

A

the anterior cerebral and the middle cerebral

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10
Q

give some causes of stroke

A

> blockage of vessel with thrombus
disease of vessel wall
disturbance of normal properties of blood
rupture of vessel wall (haemorrhage)

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11
Q

what percentage of strokes at ischaemic?

A

85%

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12
Q

what causes for ischaemic stroke are there?

A 
> large artery atherosclerosis
> cardioembolic
> small artery occlusion
> arterial dissection (rare)
> Venous sinus thrombosis (rare)
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13
Q

what percentage of strokes are haemorrhagic?

A

15%

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14
Q

what causes for haemorrhagic stroke is there?

A

> primary intracerebral haemorrhage

> secondary haemorrhage

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15
Q

give two examples of causes of a secondary haemorrhagic stroke

A

> subarachnoid haemorrhage

> arteriovenous malformation

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16
Q

what is an ischaemic stroke?

A

a clot stops blood supply to an area of the brain

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17
Q

what is a haemorrhagic stroke?

A

when blood leaks into brain tissue, there is a pressure effect on the brain

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18
Q

what is the commonest cause of a cardioembolic stroke?

A

atrial fibrillation

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19
Q

describe a lacunar stroke

A

the walls of a small vessel in the brain get thickened creating a smaller lumen. this occlusion creates a small area of damage. this is generally caused by hypertension.

20
Q

describe how a carotid dissection can lead to stroke

A

it can be idiopathic or due to trauma. the wall of the carotid tears and a clot then thrombus forms on top of that

21
Q

what can you tell about the stroke from the signs and symptoms of the patient?

A

> what side of the brain is affected
whether the lesion is in the brainstem (brainstem stroke)
whether the cortex is involved (cortical stroke)
if the lesion is in the white matter (lacunar stroke)
what blood vessel is involved

22
Q

what is TACS?

A

total anterior circulation stroke

23
Q

what is PACS?

A

partial anterior circulation stroke

24
Q

what is LACS?

A

lacunar stroke

25
Q

what is POCS?

A

posterior circulation stroke

26
Q

give an example of a lesion that would cause unilateral field loss of vision?

A

left optic nerve compression

27
Q

what lesion would cause bitemporal hemianopia?

A

chiasmal compression from the pituitary tumour

28
Q

what lesion would cause homonymous hemianopia?

A

left cerebrovascular event

29
Q

what would you expect to see in a patient with a total anterior circulation stroke?

A

> weakness
sensory defect
homonymous hemianopia
higher cerebral dysfunction

30
Q

what would you expect to see in a partial anterior circulation stroke?

A

2/3 of the TACS criteria or restricted motor/sensory deficit

31
Q

what four types of stroke can a lacunar stroke create?

A

> pure motor
pure sensory
sensorimotor
ataxic hemiparesis

32
Q

what is a sensorimotor lacunar stroke?

A

a combination of a sensory and motor stroke

33
Q

describe an ataxic hemiparesis lacunar stroke

A

> hemiparesis and ipsilateral cerebral ataxia.
small infarcts in basal ganglia or pons
intrinsic disease of single basal perforating artery

34
Q

what will a posterior circulation stroke affect?

A

the brainstem, cerebellar or occipital lobes

35
Q

what are some modifiable risk factors for stroke?

A

> high blood pressure

> atrial fibrillation

36
Q

what investigations would you carry out for stroke?

A 
> full blood count
> ECG
> CT scan
> MRI scan
> carotid doppler
37
Q

what is the aim of thrombolysis?

A

to restore perfusion before cell death occurs

38
Q

how many neurons will a typical patient lose very minute a stroke is not treated?

A

1.9million

39
Q

what are the risk factors for haemorrhage after thrombolysis?

A 
> infarct size
> vessel occlusion
> diabetes
> blood pressure
> age
> stroke severity
> tissue changes
> anti-platelets
40
Q

what should you do is a patient has an ongoing neurological deficit that came on less than 4.5 hours ago?

A

arrange an urgent CT scan then contact the stroke bleep via switchboard

41
Q

what are the contraindications to thrombolysis?

A 
> age
> over 80yr
> MI
> recent bleeding
> very high blood pressure
42
Q

what is the mortality of malignant MCA infarction?

A

up to 80%

43
Q

when should surgical decompression by hemicraniectomy be offered?

A

in individuals up to 60 years who suffer an acute MCA territory ischaemic stroke complicated by a mass cerebral oedema

44
Q

how many people that suffer a TIA will have an acute stroke in the future?

A

one third

45
Q

in TIA what is associated with a reduced risk of subsequent stroke?

A

evaluation and initiation of treatment in a specialised outpatient clinic.

46
Q

describe secondary prevention of stroke

A

> clopidogrel or aspirin
statin
blood pressure drugs (even if it is normal)

Cardiovascular system (34 decks)

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