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Neuro > Stroke > Flashcards

Stroke Flashcards

1
Q

Define an ischaemic stroke

A

Cerebral loss of blood flow to part of the brain caused by interruption of blood supply.

Results in hypoxia which can stress brain cell metabolism which can lead to anoxia. Anoxia leads to infarction which results in a stroke

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2
Q

What is the most modifiable risk factor when it comes to stroke?

A

Hypertension

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3
Q

How does hypertension cause stroke?

A

Stroke is related to blood pressure. Chronic hypertension worsens atheroma and affects small distal arteries

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4
Q

Define ischaemia

A

Lack of blood flow

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5
Q

Define Hypoxia

A

Lack of oxygen

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6
Q

Define the relationship between ischaemia and hypoxia

A

Ischaemia causes hypoxia

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7
Q

Define the term ‘stroke’

A

A focal neurological deficit due to disruption of blood supply

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8
Q

What causes stroke?

A

Interruption of supply of nutrients and oxygen, causing brain tissue damage

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9
Q

What are the causes of interruption of blood supply?

A

Changes in:

  • vessel wall
  • blood flow
  • blood constituents
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10
Q

What are the three main causes of interrupted blood supply?

A
  1. Atheroma + thrombosis of artery (Ischaemia)
  2. Thromboembolism (Ischaemia)
  3. Ruptured Aneurysm (haemorrhage)
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11
Q

What is atheroma and thrombosis?

A

Narrowing and thrombosis of artery

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12
Q

Which arteries are usually affected by atheroma and thrombosis?

A

Internal carotid artery thrombosis causes ischaemia in middle cerebral artery region

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13
Q

What is the pathogenesis of ischaemic stroke?

A
  • a few seconds of hypoxia or anoxia = ischaemia which can lead to infarction
  • infarction = damage to neurones permanent and they will not regenerate
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14
Q

Describe a regional cerebral infarct

A

A wedge shaped reflection of arterial perfusion territory. It goes soft and becomes cystic

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15
Q

When is thrombosis of atrial appendages common?

A

In patients with arrhythmia of AF

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16
Q

How does thromboembolism affect stroke?

A
  • heart with LA appendage thrombosis throws a clot into aorta and carotid arteries
  • Embolism reaches right middle cerebral artery and blocks it = ischaemia
17
Q

Why do vessels rupture?

A

Vessel walls weaken and hypertension causes an aneurysm to form

18
Q

How do ruptured vessels cause haemorrhage and distal ischaemia ?

A

Artery spasms = haemorrhage and decreased blood flow

19
Q

Name 2 common sites of ruptured vessels which cause Hemorrhagic stroke?

A

Basal ganglia and circle of willis

20
Q

Give examples of situations where levels of o2 in blood are low?

A

CO poisoing, near drowing, resp arrest

21
Q

Give examples of situations where blood supply isn’t adequate

A

Cardiac arrest, hypotension, brain swelling

22
Q

Define Watershed infarcts

A

A zonal pattern of ischaemia and infarction at interface of territories

23
Q

When do Watershed infarcts occur?

A

When prolonged HYPOTENSION occurs

24
Q

What occurs in complete loss of perfusion and oxygen?

A

CORTICAL INFARCTION

25
Q

What is a TACS?

A

Total Anterior circulation stroke

  • Unilateral weakness of face,arm and leg
  • Homonymous Hemianopia
  • Higher cerebral dysfunction (dysphasia and visuospatial disorder)
26
Q

What is a PACS?

A

Partial anterior circulation stroke

Unilateral weakness of face,arm and leg

  • Homonymous Hemianopia
  • Higher cerebral dysfunction (dysphasia and visuospatial disorder)

2/3 MUST BE PRESENT FOR PACS CLASSIFICATION

27
Q

What is a POCS?

A

Posterior circulation syndrome

  • cranial nerve palsy
    and a contralateral motor/sensory deficit
  • Bilateral motor/sensory deficit
  • Conjugate eye movement disorder
  • Cerebellar dysfunction (vertigo, nystagmus,ataxia)
  • Isolated homonymous hemianopia

ONLY ONE NEEDS TO BE PRESENT

28
Q

What is a LACS

A

Lacunar syndrome

  • Pure sensory stroke
  • Pure motor stroke
  • Senori-motor stroke
  • Ataxic hemiparesis

Neuro (16 decks)

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