Stroke

Question 1

Define stroke

Answer 1

Acute onset of neurological deficits due to a disturbance in blood supply to brain
(>24 hrs)

Question 2

Name 4 non modifiable and 6 modifiable risk factors

Answer 2

NM
Age
Gender
Ethnicity
Fam history

M
Hypertension
Hyperlipidaemia
Diabetes
Smoking 
Obesity 
Carotid artery disease

Question 3

List the types of stroke

Answer 3

HAEMORRHAGIC
intracerebral
subarachnoid

ISCHAEMIC
THROMBOTIC- lacunar occlusion
Embolic- large vessel occlusion

Question 4

Name 7 neurological symptoms that are characteristic of stroke

Answer 4

1. Aphasia
2. Dysphasia (trouble swallowing)
3. Apraxia (inability to perform certain purposeful actions)
4. Hemiparesis (weakness on one side of the body)
5. Facial weakness
6. Confusion, dizziness and visual impairments
7. Thunderclap headache

Question 5

Describe lacunar infarction

Answer 5

Small strategic strokes in penetrating arteries, feed sub cortical structures
80% clinically silent
Motor hemiplegia syndrome- infarction in post limb of internal capsule, basal ganglia or pons
MCA

Question 6

Two ways to treat haemorrhagic stroke

Answer 6

Coiling

Clipping

Question 7

Ways to treat ischaemic stroke

Answer 7

• Thrombolysis (alteplase) tPA activator

Question 8

Stroke events

Answer 8

Excitotoxicity - failure of the ion pumps, cell depolarization and water influx
• Na+, Ca2+ influx and K+ efflux
• Glutamate release and receptor activation (NMDA, AMPA, mGluR)
Peri-infarct depolarisation
- excessive reduction in calcium etc which builds up in extracellular space spreading waves of depolarisation through the brain
Inflammation - starts with microglia, also periphery