Stroke Flashcards

1
Q

what is stroke?

A

acute neurological deficit lasting >24 hours + caused by a cerebrovascular aetiology

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2
Q

what are the 2 types of stroke?

A

ischaemic

haemorrhagic

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3
Q

what kind of general symptoms may be experienced in stroke?

A

visual defects
weakness
asphasia
ataxia

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4
Q

what symptoms are there in carotid artery disease?

A

contra-lateral weakness or sensory loss

if dominant hemisphere - aphasia/ataxia

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5
Q

what symptoms are there in middle cerebral artery?

A

weakness predominantly contralateral face and arm

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6
Q

what symptoms are there in anterior cerebral artery?

A

weakness + sensory loss in contralateral leg

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7
Q

wha symptoms are there in vertebro-basilar artery disease?

A

vertigo
ataxia
dysarthria

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8
Q

what is the frontal lobe responsible for?

A
voluntary movements 
reasoning
exudative functions
personality
emotion control
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9
Q

what is the parietal lobe responsible for?

A

knowing left from right
reading/writing
body orientation
calculation

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10
Q

what is the cause of strokes?

A

infarction - thrombotic/embolic

haemorrhage - spontaneous/ trauma

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11
Q

where is the most common place for a thrombotic event?

A

middle cerebral

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12
Q

how is a stroke diagnosed?

A

clinical

CT/MRI to differentiate

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13
Q

what does an infarction look like on CT?

A

hypoattenuation (darkness) of brain parenchyma

hyperattenutation (lightness) in artery -indicated clot within lumen

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14
Q

what does a haemorrhage look like on CT?

A

hyperdense lesion

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15
Q

how is a total anterior circulation stroke classified?

A

must have 3;
unilateral weakness of face, arm, leg
homonymous hemianopia
higher cerebral dysfunction (dysphasia, visuospatial disorder)

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16
Q

how is partial anterior circulation syndrome classified?

A

must have 2:
unilateral weakness of face, arm, leg
homonymous hemianopia
higher cerebral dysfunction (dysphasia, visuospatial disorder)

17
Q

how is a posterior circulation syndrome classified?

A

1 of:
cerebellar/brain stem (CN palsy) syndrome
loss of consciousness
isolated homonymous hemianopia

18
Q

how is a lucunar syndrome classified?

A

1 of:
unilateral weakness of face, arm, leg
pure sensory stroke
ataxic hemiparesis

19
Q

what is the treatment of a stroke?

A

ABCDE

thromboylsis

20
Q

what is the protocol of thrombolysis?

A

if seen <48 hours after onset of symptoms + no complications

21
Q

what is the contra-indications?

A

haemorrhagic stroke

22
Q

what is secondary prevention for stroke?

A

anti-hypertensives

clopidogrel

23
Q

what is the CHAD2 score

A

risk factor based approach

24
Q

what is a TIA?

A

sudden onset of focal CNS phenomena due to temporally occlusion of park of the cerebral circulation

25
what is a TIA usually caused by?
emboli
26
how long does a TIA usually last for?
<24 hours
27
what is a amaurosis fugax?
curtain descending | emboli passes through retinal artery
28
what symptoms are not common in TIA and stroke?
global features - dizziness/syncope is not common in TIA
29
what is the treatment for a TIA?
control CVS risk factors anti platelet drugs warfarin indications
30
what type of anti-platelet drugs are used/
clopidogrel
31
what is the MOA of clopidogrel?
thienepyrdine inhibits platelet aggregation by modifying ADP receptors
32
what is the most common origin of TIAs?
stenosis of internal carotid artery
33
how is stenosis of an internal carotid artery treated?
carotid endartectomy
34
what is the driving indications for those who have had a TIA?
avoid driving for 1 month | inform DVLA if multiple attacks in a short period of time