Stroke Flashcards
what is a stroke?
An experience of persisting neurological complications of CVS disease NOT a diagnosis
is there a higher incidence of cerebrovascualr disease over coronary vascular??
YES
Name some stroke mimics
(1/3 of all presentations are mimics) Seizure!! sepsis syncope delirium
scale for assessing stroke mimics
ROSIER score
requirements for full stroke diagnosis
Type
Size
Laterality
Cause
MOST severe ischaemic stroke?
Total Anterior Circulation Syndrome (TACS) (5% alive and independent @ 1 year)
BEST prognosis ischaemic stroke?
Lacunar Syndrome (LACS) (60% alive and independent at 1 year)
signs of TACS
Hemiplegia
Homonymous hemianopia
what happens in LACS
small infarcts in deep arteries
what is PACS?
Partial anterior circulation syndrome (PACS)
2/3/ features present in TACS
what is POCS
posterior circulation syndrome (POCS)
CN palsies
GOOD prognosis (60%)
2 types of haemorrhgaic strokes
Primary intracerebral
Secondary intracerebral
Primary intracerebral examples
Hypertension (deep bleed) Amyloid angiopathy (lobar)
Secondary intracerebral examples
Arteriovenous malformation
Aneurysm
Tumour
right side of brain important for
spatial orientation
left side of brain important for
spoken language
main causes of ischaemic stroke
50% athero embolism
25% intracranial small vessels disease
20% cardio-embolic
causes 50% of cardio embolic strokes
AF
score for assessing risk factors
CHADVAScore
Acute management of stroke
Thrombolysis (benefit diminishes 5 post episode) Imaging Swallow assessment Nutrition and hydration Antiplatelets Stroke unit care DVT prophylaxis
Secondary prevention of stroke
Medication
lifestyle
Carotid surgery (endarterectomy)
Invx for stroke
Full lipid profile BP Carotid scan ECG Consider 72 hr ECG, ECHO
ABC of stroke prevention
Antithrombotic therapy (antiplatelet, anticoagulant) BP Cholesterol Diabetes Don't smoke
