Stroke Flashcards
What are the components of CHADSVAS?
Congestive heart failure Hypertension Age >75 Diabetes mellitus Stroke Vascular disorders Age >65 Sex female
What are the components of HASBLED?
Hypertension Abnormal liver or renal function Stroke Bleeding Labile INR Elderly >65 Drugs and alcohol
Define a TIA
Sudden onset of neurological symptoms that can be located to a vascular territory that lasts <24 hours
What are the 2 types of stroke?
Ischaemic
Haemorrhagic
Define stroke
A clinical syndrome caused by disruption of blood supply to an area of the brain. It consists of rapidly developing symptoms and signs of loss of focal CNS function
What proportion of people have a stroke every year?
2 in 1000
What are the components of Virchow’s triad?
Abnormalities of vessel wall
Abnormality of blood components
Abnormalities of blood flow
Where might an embolism that causes a stroke have come from?
Valve disease
AF
Recent MI
How can some stroke symptoms get better?
Surrounding the central necrotic zone is an is haem is penumbra. This remains viable for a time and may recover of blood flow is restored.
What features define a TACS?
Hemiplegia
Hemianopia
Cortical deficits eg. Dysphasia
What features define a PACS?
2 of:
Hemiplegia
Hemianopia
Cortical deficit
What are the features of a lacunar stroke?
Pure motor or sensory loss
Ataxia hemiparesis
What are the features of a POCS?
Evidence of a brainstem lesion
Homonymous hemianopia
Give some complications of a stroke
Aspiration pneumonia DVT/PE MI/HF/arrhythmia Fluid imbalance Epilepsy Pressure sores
What is the management of a stroke?
Aspirin 300mg
Thrombolysis with alteplase - if seen within 4.5 hours of sx onset. Need CT to exclude bleed.
Thrombectomy if candidate
What medications would you think about starting after a stroke?
Statin
BP tablets
Antiplatelet
Anticoagulant if AF
