Stroke

Question 1

Modifiable risk factors?

Answer 1

Hypertension
Smoking
DM
Hyperlipidaemia
Alcoholism 
Oestrogen based contraception

Question 2

Non-modifiable risk factors?

Answer 2

Previous TIA/stroke
Old age 
Being male 
FH of stroke 
IHD
Malignancy 
Genetic hypercoagubility 
Vascular malformations

Question 3

Pathology?

Answer 3

Can be occlusive or haemorrhagic
Occlusive - infarct blocks blood supply to an area of the brain –> an ischaemic core and penumbra of tissue –> loss of function
Haemorrhage - bleed –> tissue damage from blood infiltration and high pressure –> encapsulation in fibrous and glial tissue

Question 4

Signs and symptoms of an anterior cerebral artery stroke?

Answer 4

Contralateral UMN signs and corticosensory loss
Behaviour abnormalities
Dominant speech difficulties or non-dominant hemineglect

Question 5

Signs and symptoms of a middle cerebral artery stroke?

Answer 5

Controlalateral face UMN weakness and corticosensory loss
Behaviour abnormalities
Hemiparesis

Question 6

Signs and Symptoms of a posterior cerebral artery stroke?

Answer 6

Vital function loss
contralateral hemiparesis
Hemisensory loss

Question 7

Signs and symptoms of a lacunar artery stroke?

Answer 7

Non cortical: either purely motor or purely sensory
Dysarthria
Hemiparesis

Question 8

Investigation and Findings?

Answer 8

Urgent CT/MRI brain scan
FBC
Biochem
U+Es 
Blood pressure

Question 9

Management?

Answer 9

ABCD
Recuss
Assess pros and cons of thrombolysis
Anticoagulants when haemorrhage excluded

Question 10

Complications?

Answer 10

Lifetime focal symptoms
Coma
Death