Stroke

Question 1

Modifiable risk factors?

Answer 1

HypertensionSmokingDMHyperlipidaemiaAlcoholism Oestrogen based contraception

Question 2

Non-modifiable risk factors?

Answer 2

Previous TIA/strokeOld age Being male FH of stroke IHDMalignancy 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 lossBehaviour 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 lossBehaviour 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 DysarthriaHemiparesis

Question 8

Investigation and Findings?

Answer 8

Urgent CT/MRI brain scanFBCBiochemU+Es Blood pressure

Question 9

Management?

Answer 9

ABCD RecussAssess pros and cons of thrombolysis Anticoagulants when haemorrhage excluded

Question 10

Complications?

Answer 10

Lifetime focal symptoms ComaDeath