Stroke

Question 1

What score helps to ensure the diagnosis of stroke is right?

Answer 1

The ROSIER score

Question 2

What 2 points score you negative points for the ROSIER score?

Answer 2

• Loss of consciousness
• Seizure activity.

Score of > 0 stroke is likely.

Question 3

What 3 features need to be present for a TACS (total anterior circulation syndrome)

Which arteries affected?

Answer 3

Hemiplegia involving at least 2 of face arm and leg +/- hemisensory loss.

Homonymous hemianopia

Cortical signs (dysphasia, neglect)

Blockage of both anterior and middle cerebral arteries.

Question 4

Presentation of PACS (partial anterior circulation syndrome)

Answer 4

2 of:

Unilateral weakness +/- hemisensory loss
Homonymous hemianopia
Cortical dysfunction e.g. dysphasia, visuospatial problems

Question 5

Presentation of POCS (posterior circulation stroke)?

Answer 5

One of the following:

• Isolated homonymous hemianopia
• Cerebeallar or brain stem syndromes
• `+/- Confusion or mood changes

Question 6

Lacunar syndrome presentation?

Answer 6

Multiple small vessel infarcts in basal ganglia and thalamus.

One of the following:

• Purely sensory stroke.
• Ataxic hemiparesis
• Unilateral weakness +/- sensory symptoms in face, arm, legs.

Question 7

Imaging in stroke?

Answer 7

CT 1st line if presenting in acute phase

MRI 1st line if presenting after 1 week or with mild deficits suggesting a small lesion.

Question 8

Management of ischaemic stroke?

Answer 8

If presenting within 4.5 hours: Thrombolyis (alteplase)

If presenting >4.5 hours : 300mg aspirin (commenced within 48hours of stroke and continued for at least 14 days)

Question 9

What is ABCD2 score used to calculate?

Answer 9

Used to assess stroke risk for patients who have had a TIA.

Question 10

Components of ABCD2 score?

Answer 10

A (age > 60 = 1)
B (blood pressure >140/90 = 1)
C unilateral weak = 2, speech no weak =n 1
D (duration >60 = 2, 10-59 = 1)
D (diabetes = 1)