Stroke

Question 1

what is a stroke

Answer 1

infarction of brain tissue due to lack of blood supply

Question 2

what is a TIA

Answer 2

temporary neurologic deficit relative to ischemia that improves when blood supply is restored (symptoms usually last less than one hour)

Question 3

why are identifying TIAs so important

Answer 3

they are risk factors for strokes and need to treat them ASAP to prevent a stroke

Question 4

causes of stroke (4)

Answer 4

• Haemorrhagic- 15%
• Vertebrobasilar
• Non- carotid
• Carotid
  Ischemic

Question 5

pathophysiology of carotid stroke

Answer 5

Diseased carotid artery- blood clot breaks off and lodges in cerebral artery causing a stroke

Question 6

what are risk factors in the stroke predictive risk score (5)

Answer 6

A-Age
B-BP
C-clinical presentation
D-duration of symptoms/ diabetes

Question 7

surgical treatment for a TIA and what is it and when is each treatment used (2)

Answer 7

Carotid Endarterectomy (CEA): open artery- remove plaque and close with a patch

• Carotid artery stenting (CAS) is not justified and only used for patients with a ‘hostile neck’

Question 8

indication of an CEA

Answer 8

• TIA
• carotid stenosis/disease
• symptomatic carotid disease

Question 9

investigations if a patient comes to clinic after TIA

Answer 9

-doppler
-USS
examination
-MRI
-CT

Question 10

complications of CEA

Answer 10

• bleeding- death
• stroke
• nerve damage

Question 11

which nerves can be damaged in CEA

Answer 11

• Vagus n.- laryngeal n.- vocal cord paralysis
• Mandibular n.- orbis ocularis damage- cant smile
• Hypoglossal n. (cant stick tongue out)
• Glossopharyngeal n.