Stroke Flashcards
4 causes of stroke
- occlusion
- cns bleed
- atheroemoboli
- cardiac emboli
window for thromboylsis
3.5-4 hours
why can you only give thrombolysis in certain window?
can cause bleed
what scoring system do you use to see if thrombolysis can be used?
NHISS
why might BP increase in stroke?
because there is an occlusion, so BP increases as AUTOREGULATORY mechanism
RF for stroke
increase BP increase cholesterol smoking diabetes arrhythmia - in adolescents valvular heart disease
signs of stroke
sudden meningism headache hemiplegia vision disturbance
what to look for in suspected stroke - what vitals to check and movements they can do
bp
blood glucose
temp
ability to swallow
differentials for stroke
intercranial bleed
tumour
MS
action plan for stroke
- airway
- pulse, BP, ECG
- blood glucose
- CT/MRI
- thrombolysis
- antiplatelet
investigations for stroke
FBC, clotting, UE, LFT, ESR, glucose, cholestrol ECG CT MRI carotid doppler
3 types of stroke
- infarctive
- hemorrhagic
- ischemic
infarctive stroke features
thromoemboli
atherosclerosis
emboli from heart
hemorrhaic stroke features
intracerebelar cerebellar sub arach subdural extradrual
ischemia stroke features
decrease in 02, glucose, ATP, energy
Umbra - tissue with ischemic death
pen umbra - potential for infarction
what is the classification for strokes
bamford
4 classification for strokes
TACI
PACI
LaCi
PoCi
TACI features and artery affected
increased cerebreal dysfunction
hemanopia
ipsilateral motor/sensory defect
MCA
PACI features and artery affected
2/3 TACI
MCA, ACA
LaCI features and artery affected
motor, sensory, ataxic, hemiparesis
small deep perforating artery
PoCi
cranial nerve palsy
contralateral defect
brainstem, cerebellum, occipital lobe
feature of posterior stroke
horners
features of horners
miosis
ptosis
causes of horners features
from sympathetic injury and leisons
thrombolysis criteria
check criteria to see if eligible
use alteplase
18+ y/o
measurable neurological defect
4 reasons for stroke in young person
- structural heart disease
- undiagnosed arrythmia
- autoimmune
- haematological disease
what test can you do for stroke?
pronator drift
