Stroke

Question 1

80-85% of strokes?

Answer 1

Ischaemic

Question 2

15-20% of strokes

Answer 2

Haemorrhagic

Question 3

Common causes of haemorrhagic stroke?

Answer 3

hypertension or weakened blood vessel wall

Question 4

Virchows triad

Answer 4

Endothelial injury, circulatory stasis, hypercoagulable state

Question 5

Non-modifiable risk factors for stroke (5)

Answer 5

Age, FH, Gender, Race, Previous Stroke

Question 6

Modifiable risk factors for stroke (9)

Answer 6

hypertension, hyperlipidaemia, smoking, diabetes, Afib, CHF, Alcohol excess, obesity, physical activity

Question 7

Rarer causes of Stroke

Answer 7

vasculitis, Protein C, S or antithrombin III deficiency, factor V leiden mutation

Question 8

Things Stroke can mimic

Answer 8

hypoglycaemia, seizure, migraine, other metabolic issues - hyponatraemia, space occupying lesions,

Question 9

Investigations for stroke?

Answer 9

Glucose, lipids, thrombophilia (young), CT angiography of aortic arch, atheroembolism, ECG, ECHO, paroxysmal AF

Question 10

Medical management of Stroke

Answer 10

aspirin 75mg, Clopidogrel 75mg daily/dipyrimadole MR 200mg BD, statins, in AF anticoagulation, anti-hypertensives

Question 11

Surgical Management of Stroke

Answer 11

haematoma evacuation, relief of ICP, obstructive hydrocephalus, carotid enderterectomy

Question 12

Emergency management of stroke

Answer 12

thrombolysis if ischaemic, even in TIA. Management is multidisciplinary.