Stroke Flashcards
Define the 5 main aspects of a stroke.
Rapidly developping Focal signs Symptoms lasting >24 hours Loss of brain function Vascular origin
What important things should always be noted when someone has a stroke?
Time of onset
What were the symptoms
What are the symptoms now
How did the symptoms progress
What scoring system is used to diagnose a stroke?
Rosier
What score in the Rosier system makes a stroke likely?
> 0
Stroke is the experience of persisting …… symptoms of ………….. disease
Neurological
Cardiovascular
Stroke is a diagnosis?
FALSE
Name the 3 most types of strokes in order of incidence.
Infarct
Haemorrhage
Subarachnoid haemorrhage
Name the 3 subtypes of an infarct.
Atheroembolic
Cardioembolic
Small vessel
How long does a TIA last?
<24 hours
How long does a stroke last?
> 24 hours
How do you determine between different types of stroke?
CT scan
What 4 things should be done in the rapid assessment?
History
Carotid imaging
ECG
Blood tests
Why is an ECG done?
To look for AF
After a TIA, what should patients be started on to prevent a stroke?
Anticoagulation and anti platelet
Why is DVT/PE a risk of a stroke?
After a stroke patient are usually bed bound and immobile
What assessment is essential in the first 4 hours following a stroke?
Swallow assessment
Why is a swallow assessment done?
To check if the patient swallow is still ok as if it is not they risk aspiration which can make them very unwell
Always think aspiration pneumonia
What imaging should be done if a small infarct cannot be seen on CT?
MRI
What must be given ASAP after a stroke?
300mg Aspirin
What must you do before giving Aspirin or another anti platelet?
A CT to check that there has not been a bleed
What is the gold standard way of reducing risk of DVT’s?
Intermittent pneumatic compression
Why is heparin now given to prevent DVT?
Benefit is outweighed by bleeding risk
What is done if swallow screen is abnormal?
Assessment by speech and language therapist
When might an NG tube be used or textured diet and thickened fluids?
Abnormal swallow assessment
What should patients with an acute stroke also be screened for?
Malnutrition
On admission and weekly after
When should patients be referred to a dietician?
If NG tube or textured foods is needed
Cardioembolic?
Fibrin dependant
‘Red thrombus’
HEART
Atheroembolic?
Platelet dependant
‘White thrombus’
ACS
What is the most common site of an atheroembolic stroke?
Carotid artery
Small vessel?
Arteriosclerosis
Embolism
BRAIN
What conditions are risk factors for small vessel stroke?
Diabetes
Hypertension
What tests are done to find out the type of stroke?
CT or MRI
What tests are done to find the cause of the stroke?
Carotid scan Angiogram ECG ECHO 24 hour tape
Name risk factors.
Smoking Alcohol BP Glucose Lipid profile
What should be given if the stroke is cardioembolic/AF?
Anticoagulants
When is anti platelets given?
When the stroke is not cardioembolic
What is the first line anti platelet?
Clopidogrel
When should a statin not be given?
AF
AF is associated with a 5 fold increase of?
Ischaemic stroke
