Stroke Flashcards
What are the two main types of stroke?
Infarct
Haemorrhagic
What is the biggest cause of ischaemic strokes?
Large artery atherosclerosis (common carotid)
What are the biggest causes of cardioembolic stroke?
Infective material (infective endocarditis) Atrial Fibrillation
What are the 4 stroke subtypes? What are their occurrence rates?
Total Anterior Circulation (20%)
Partial Anterior Circulation (35%)
Lacunar (20%)
Posterior Circulation (25%)
What is the % risk of stroke reoccurence?
14%
What proportion of TIA patients have another stroke?
1/3
What are the symptoms of stroke?
RAPID ONSET:
Loss of Power, Speech, Sensation, vision, coordination
What is the expected history of symptoms?
Time of onset and duration
Loss of consciousness
Fit
Incontinence
Which factors suggest haemorrhage?
Headache
Vomiting
Stiffness
Photophobia
What are the non modifiable risk factors for stroke?
Age
Race
Family history
What investigations would you take for a suspected stroke?
Bloods: FBC, Lipids ECG CT MRI Carotid doppler
If the onset of neurological deficit was less than 4.5 hours ago, what is the first thing you do?
CT
What will be detected on examination?
Loss in motor/sensory/speech function
Neglect
Ataxia
Vertigo
Which arteries are involved with a LAC stroke?
Lenticulostriate arteries
What does a stroke presenting with Horner’s Syndrome and pain suggest?
Carotid dissection
What can signs and symptoms tell you about the stroke?
Side Brainstem Cortex Deep Which blood vessel
What are the modifiable risk factors for stroke?
Hypertension
Atrial fibrillation
What is the common presentation of a TACS? What is the common cause?
Weakness, sensory deficit
Homonymous hemianopia
Higher cerebral dysfunction
Occlusion of proximal MCA/ICA
What is the common presentation of a PACS?
2/3 of TACS presentation
What is the most common form of LACS?
Pure motor (1/2 side of body)
In which way is an MRI superior to a CT for stroke?
MRI better at showing ischaemic strokes
What the requirement for thrombolytic treatment after stroke?
<4.5hrs
rt-PA
What are the contraindications for thrombolytics?
Age
Recent MI
When is a hemicraniectomy suggested for stroke?
Patient <60
Massive cerebral oedema
Within 48hrs
