Stroke Flashcards
What is the Bamburgh classification of a pontine stroke
POCS
Pontine area is supplied by posterior circulation
What treatments are done for haemorrhagic stroke?
- Reassess medication if previously on anticoagulation
- Blood sugar control
- Oxygen therapy if hypoxic (not routine)
- Blood pressure control
What treatments are done for ischaemic stroke?
- Thrombolysis
- Decompressive hemicraniectomy (if MCA infarct)
- Aspirin
When should brain imaging be performed urgently within 1h for patients with acute stroke
- Indication for thombolysis
- GCS <13
- On anticoagulation/ known bleeding tendency
- Unexplained progression/ fluctuation of symptoms
- Papilloedema, neck stiffness, fever
- Severe headache at onset of stroke symptoms
What drug is given prophylactically for people who have had ischaemic stroke
Clopidogrel
Anticoagulation treatment is not routinely given for acute stroke.
In which type of stroke would anticoagulation be given?
- Cerebral venous sinus thrombosis
- Risk of DVT, PE (including smokers, those with complete leg paralysis)
What are the 4 features of Gerstmann syndrome
- Inability to write (agraphia)
- Inability to do maths (acalculia)
- Inability to identify one’s own or another’s fingers (finger agnosia)
- Inability to distinguish between left and right sides of one’s body
Problems with the following indicate a stroke WHERE
- motor loss
- behaviour, personality
- emotions
- memory
- planning, judgement
- expressive aphasia
FRONTAL LOBE
- motor loss
- behaviour, personality
- emotions
- memory
- planning, judgement
- expressive aphasia
Problems with the following indicate a stroke WHERE
- sensory loss
- visual inattention
- telling left from right
- intelligence, reasoning
- language
PARIETAL LOBE
- sensory loss
- visual inattention
- telling left from right
- intelligence, reasoning
- language
Problems with the following indicate a stroke WHERE
- receptive aphasia
- memory
- emotions
- language
- hearing
- smell
TEMPORAL LOBE
- receptive aphasia
- memory
- emotions
- language
- hearing
- smell
Problems with the following indicate a stroke WHERE
- consciousness
- heart rate
- sleep/ wake cycles
- breathing
BRAINSTEM
- consciousness
- heart rate
- sleep/ wake cycles
- breathing
Problems with the following indicate a stroke WHERE
- balance
- coordination
- visual perception
- skilled motor activity
CEREBELLAR
- balance
- coordination
- visual perception
- skilled motor activity
DVLA rules:
When can a patient with a first seizure with normal MRI and EEG resume driving
After 6 months
DVLA rules:
When can a patient with a simple vasovagal syncope and no other neurological problems resume driving
Immediately. No restrictions.
DVLA rules:
When can a patient who has had a single TIA resume driving
1 month
DVLA rules:
When can a patient who has made a good recovery from a stroke resume driving
1 month
What is the time window for which someone is eligible for thrombolysis
<4.5h from time of symptom onset
If stroke happened overnight, uncertain of when exactly it happened, do NOT give thrombolysis
What does ABCD2 in assessing risk of recurrence of TIA patients stand for
Age Blood pressure Clinical features Duration Diabetes
Which type of stroke does MI increase risk of? Why?
Ischaemic stroke.
Causes low BP.
Get akinetic segment in ventricles which may cause formation of mural thrombus (which then travels to brain).
May cause acute arrhythmias that throw clots out
