Stroke Flashcards

1
Q

What two paired arteries are responsible for blood supply to the brain

A

Vertebral and Internal Cartoid

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2
Q

Where does internal carotid arise from

A

bifurcation of the left and right common carotid arteries (C4)

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3
Q

What is the path of the ICA

A

Moves within cartoid sheath -> enter brain via carotid canal in temporal bone -> pass anteriorly through the cavernous sinus

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4
Q

What does the ICA give rise to

A

Opthalmic artery
Posterior communicating artery
Anterior cerebral artery

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5
Q

What does the opathalmic artery supply

A

Structures of orbit

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6
Q

What does the posterior communicating artery supply

A

Acts as an anastamotic ‘connecting vessel’ in the Circle of Willis

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7
Q

What does the anterior cerebral artery supply

A

Part of the cerebellum

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8
Q

What is the path of the vertebral arteries

A

Arise from subclavian -> ascend through posterior neck in foramen transversarium -> enter cranial cavity through foramen magnum -> covnerge to form basilar artery

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9
Q

What do the vertebral arteries give off

A

Meningeal branch
Anterior and posterior spinal arteries
Posterior inferior cerebellar artery

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10
Q

What does the meningeal branch supply

A

Falx cerebelli (sheet of dura matter)

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11
Q

What do the anterior and posterior spinal arteries supply

A

Spinal cord

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12
Q

What does the posterior inferior cerebellar artery supply

A

Cerebellum

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13
Q

What are the 3 main constituents of the circle of willis

A

Anterior cerebral artery - terminal branch of interal carotid
Internal carotid artery - proximal to the origin of the middle cerebral arteries
Posterior cerebral artery - terminal branch of vertebral

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14
Q

What does the anterior communicating artery do

A

Connects two ACAs

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15
Q

What does the PCA do

A

Branch of internal carotid, connects the ICA to the posterior cerebral artery

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16
Q

What is a stroke

A

focal neurological deficit of vascular origin lasting more than 24 hours or leading to death
Disease of the blood vessels

17
Q

What are the causes of intracerebral haemorrhage

A

Anatomic: small vessel disease, amyloid angiopathy, AVMs (abnormal connection between arterial and venous system)
Haemodynamic: hypertension
Haemostatic factors: anticoagulants, anti-platelets, thrombolytic
Other: recreation drugs, vasculitis

18
Q

What is white on a brain scan

A

thrombus, bone, haemorrhage, clot

19
Q

What are the causes of ischaemic stroke

A

cardiac, large vessel atherosclerosis, small vessel disease
Low flow - thrombotic occlusion or embolism
AF can cause stasis
Carotid artery atherosclerosis causes 30%

20
Q

What are the signs of ACA infarcation

A

Contralateral hemiparesis - leg more than arm/face

Cortical signs: dysphasia, emotional changes

21
Q

What are the signs of MCA infarction

A
Contralateral hemiparesis
Contralateral hemi sensory loss
Cortical:
Contralateral hemianopia 
Contralateral hemi neglect
Dysphasia (left MCA)
22
Q

What are the signs of PCA infarcation

A

Contralateral hemianopia

Contralateral hemi neglect

23
Q

What are the signs of vertebrobasilar territory lesion

A
Nausea and vomiting (sits in medulla)
Diplopia (CN III, III, VI sits in the midbrain of the pons)
Vertigo
Ataxia
Hemi/quadriplegia
Visual filed defect
Coma
24
Q

What causes Lacunar stroke

A

Small vessel disease from MCA affect sub-cortical structures: internal capsule and basal ganglia (thalamus, globus pallidus, substantia nigra)

25
What are the signs of Lacunar stroke
``` Pure hemiparesis Pure hemi sensory loss Sensorimotor stroke Ataxic hemiparesis No cortical features Better prognosis than large vessel strokes affecting cortex ```
26
What is TIA
Acute loss of coal cerebral or monocular function (symptoms < 24 hours) Due to inadequate cerebral/ocular blood supply Result of arterial thrombosis or embolism Clinical diagnosis without specific diagnostic test
27
What are the non-focal symptoms of TIA
faintness, dizziness, light headedness, confusion, mental disorientation
28
What causes focal transient neurological attacks
focal cerebral ischaemia, migraine aura, partial epilepsy, Labyrinthine disturbances (Meniere's disease, BPPV, Benign recurrent vertigo, Labyrinthitis/vestibularneuronitis)
29
What is migrane with aura
Positive phenomena 5-20 minutes Visual symptoms may be homonymous, unilateral or central Flashes of light, zig zag lines, scintillations, fortification spetra build up or expand Paraesthesia or heaviness in one or other limbs Spreads in minutes hand to elbow then face into tongue
30
What is transient global amnesia
Characteristics clinical syndrome Middle-aged or elderly Sudden disorder of memory For a period pt has both anterograde and retrograde amnesia