Stroke Flashcards
Stroke symptoms
loss of power
loss of sensation
loss of speech
loss of vision
loss of coordination
Neurolical history/examination would look at
motor (clumsy/weak limbs)
sensory (loss of feeling)
speech
vision (loss in one eye etc)
What is a stroke?
damage to the part of the brain due to blockage of a blood vessel by thrombus or embolus
causes of stroke
blockage of vessel with thrombus or clot
disease of vessel wall
disturbance of normal properties of blood
Ischaemic storke %
85%
Haemorrhage stroke %
15%
ischaemic stoke
blood clot stops supply to the brain
haemorrhage stroke
blood leaks into the brain
common cause of cardioembolic stroke
atrial fibrillation
fibrillation
irregular HB that can lead to blood clots
What part of the brain is effected by stroke?
cortex (deep white matter)
left or right side
carotid territory
Why bother localising stroke?
confirms diagnosis
imaging
indication of cause
indication of prognosis
TACS
PACS
LACS
POCS
total anterior circulation stroke
partial anterior circulation stroke
lacunar stroke
posterior circulation stroke
risk factors for stroke
modificable
high BP
atrial fibrillation
obesity
diabetes
stress
risk factors for stroke
non - modifiable
age
race
family history
Stroke investigation
Blood tests (FBC, platelets, lipids)
ECG (24 hour ECG)
CT scan
MRI scan
Echo (to look for clots)
Aims of treating thrombolysis is to
restore perfusion before cell death occurs
Risks of thrombolysis
haemorrhage
Alteplase
thrombolytic drug used to break up thrombus (used in MIs and Stroke)
Transient ischaemic attack (TIA)
warning or mini stroke
prompt evaluation is needed (medical emergency)
secondary prevention of stroke
clopidogrel (anti-thrombotic therapy)
statin
BP drugs
thrombolysis
3 anti-platelet agents
aspirin
dipyridamole
clopidogrel
