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Ageing > Stroke > Flashcards

Stroke Flashcards

1
Q

What is a stroke?

A

Rapidly developing clinical symptoms and signs of focal (sometimes global) loss of brain function
Symptoms >24 hours or leading to death
Vascular origin

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2
Q

What is a TIA?

A

Stroke <24 hours

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3
Q

What causes an intracerebral haemorrhage (leading to stroke)?

A

Structural abnormality
Hypertension
Amyloid angiopathy (friable blood vessels)

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4
Q

What are the types of infarcted stroke?

A

Atheroembolic
Cardioembolic
Small vessel disease

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5
Q

What causes an atheroembolic stroke?

A

Platelet dependent - white thrombus

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6
Q

What causes a cardioembolic stroke?

A

Fibrin dependent - red thrombus

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7
Q

What causes small vessel disease (leading to stroke)?

A

Arteriosclerosis
A fib
Microatheroma (do carotid scan)

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8
Q

How are cerebral infarctions classifed by the oxford community stroke project criteria?

A

Total anterior circulation infarct (TACI)
Partial anterior circulation infarct (PACI)
Lacunar infarct (LACI)
Posterior circulation infarct (PACI)

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9
Q

What are functions of the frontal lobe?

A

Personality
Emotional response
Social behaviour

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10
Q

What does a lesion in the frontal lobe cause?

A 
Disinhibition
Lack of initiative 
Antisocial behaviour
Impaired memory
Incontinence
Grasp reflexes
Anosmia
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11
Q

What are the functions of the dominant parietal lobe?

A

Calculation
Language
Planned movement
Appreciation of size, shape, weight and texture

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12
Q

What does a lesion in the dominant parietal lobe cause?

A 
Dyscalculia
Dysphasia
Dyslexia
Apraxia
Agnosia
Homonymous hemianopia
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13
Q

What are the functions of the non-dominant parietal lobe?

A

Spatial orientation

Construction skills

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14
Q

What does a lesion in the non-dominant parietal lobe cause?

A 
Neglect of non-dominant side
Spatial disorientation
Constructional apraxia
Dressing apraxia
Homonymous hemianopia
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15
Q

What is the function of the occipital lobe?

A

Vision

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16
Q

What would a lesion in the occipital lobe cause?

A

Homonymous hemianopia
Hemianopic scotoms
Visual agnosia
Impaired face recognition (prosopagnosia)
Visual hallucinations (lights, lines, zig-zags)

17
Q

What are the functions of the dominant temporal lobe?

A

Auditory perception
Speech, language
Verbal memory
Smell

18
Q

What would a lesion in the dominant temporal lobe cause?

A 
Dysphasia
Dyslexia
Poor memory
Complex hallucinations (smell, sound, vision)
Homonymous hemianopia
19
Q

What are the functions of the non-dominant temporal lobe?

A

Auditory perception
Music, tone sequences
Non-verbal memory (faces, shapes, music)
Smell

20
Q

What would a lesion in the non-dominant temporal lobe cause?

A

Poor non-verbal memory
Loss of musical skills
Complex hallucinations (smell, sound, vision)
Homonymous hemianopia

21
Q

What are investigations for stroke?

A 
CT scan
MRI scan (better for infarct)
Carotid scan
Angiogram
ECG/ 24 hr tape
ECHO
22
Q

What are risk factors for stroke?

A

Lipid profile
BP
Glucose
Smoking

23
Q

What is management of stroke?

A

Thrombolysis/ thrombectomy - gold standard is IV tPA e.g. alteplase
Swallow assessment
Antiplatelets
Stroke unit care

24
Q

In what time frame should IV tPA be given after stroke?

A

<4.5 hours from onset of symptoms

25
Q

When is endovascular therapy used in stroke?

A

If patient responds poorly to thrombolysis

If patients have very high bleeding risk and can’t get thrombolysis

26
Q

What is the secondary prevention given for stroke?

A 
Anticoagulants if cardioembolic/ AF
Antiplatelets (clopidogrel) if not cardioembolic
Stop smoking
Statins
Manage BP
27
Q

What makes up the CHA2DS2VASc score?

A 
Congestive heart failure/ LV dysfunction
Hypertension
Age >75 yrs
Diabetes
Stroke/ TIA/ thrombo-embolism
Vascular disease
Age 65-74
Sex (female)

Ageing (6 decks)

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