Stroke Flashcards
What is the difference between a stroke and a TIA?
Stroke >24 hours
TIA <24hours
Describe how atherosclerosis causes stroke
Thrombus forms on arterial atherosclerotic plaque in intracranial or internal carotid artery
Grows until artery is occluded or a piece can break off and block an artery downstream
Describe how cardioembolism causes stroke
Acute clots forms in the heart due to a change in blood flow (MI, AF, valve disease etc)
These embolise to cerebral arteries
Describe the pathology of a non-atheromatous stroke?
Thrombus in arteries developed through vasculitis or aortic dissection
How does small vessel occlusion occur?
Thrombosis in small arteries damaged by longstanding hypertension
Subarachnoid haemorrhage usually occurs as a result of….
Ruptured Berry aneurysm
What are the 3 criteria for TACS?
Contralateral motor or sensory deficit
Visual field defect
Higher cortical dysfunction
What are the criteria for PACS?
Two of:
Contralateral motor or sensory deficit
Visual field defects
Higher cortical dysfunction
Which areas does a lacunar stroke affect?
Thalamus, basal ganglia and internal capsule
How does lacunar stroke present?
Pure motor deficit OR Pure sensory OR Ataxic hemiparesis WITHOUT Higher cortical dysfunction or POCS symptoms
What are the criteria for POCS?
Any of: Isolated hemianopia Bilateral motor and sensory deficit CN deficits Cerebellar symptoms
How does a stroke in the dominant hemisphere present?
Patient with insight
Difficulty reading and writing
Aphasia
How does a stroke in the non-dominant hemisphere present?
Patient without insight
Neglect and spatial disorientation
Apraxia
How does an infarct in the anterior cerebral artery present?
Contralateral lower limb motor and sensory deficit
Urinary incontinence
Behaviour change and disinhibition
How does an MCA infarct present?
Contralateral motor and sensory deficit usually in upper limb
Higher cortical dysfunction
Contralateral hemianopia