Stroke

Question 1

What is a stroke

Answer 1

sudden focal neurological deficit with symptoms lasting >24 hours with presumed vascular origin

Question 2

List mimics of stroke

Answer 2

Seizures 
Sepsis 
Hypoglycaemia 
Space occupying lesion SOL
delirium 
syncope 
functional 
encephalopathy 
dementia

Question 3

What scoring system is used for stroke

Answer 3

Rosiers score

Stroke > 0

Question 4

What are the different types of stroke

Answer 4

Haemorrhagic
Subarachnoid haemorrhage
Infarct

Question 5

Give causes for haemorrhagic stroke

Answer 5

Hypertension
Amyloid angiopathy
Structural abnormalities

Question 6

Give causes for ischaemic stroke

Answer 6

cardioembolic - AF
small vessel disease - in brain, thrombosis in situ
atherembolic - carotid disease
other - thrombophilia, sepsis, venous sinus thrombosis

Question 7

What is the first line imaging for stroke

Answer 7

CT scan

If still unsure, do MRI

Question 8

What will show on CT if it is a haemorrhagic stroke

Answer 8

Bright white acutely,

CT is not sensitive after 1 week

Question 9

What will show on CT if it is an ischaemic stroke

Answer 9

Dark spot, this doesnt show up immediately

Because of a build up of fluid and oedema

Question 10

What does an infarct look like on MRI

Answer 10

Bright white, fades after 3 weeks

Question 11

What does a haemorrhagic stroke look like after 3 weeks

Answer 11

Dark spot

Question 12

How do you manage an ischaemic stroke

Answer 12

CT scan to rule out haemorrhage 
Thrombolysis <4.5hrs
\+- thrombectomy <6hrs
Aspirin 300 mg 
Stroke care unit admission

Question 13

How do you manage a haemorrhagic stroke

Answer 13

CT scan
Reverse anti-coagulation (to stop bleeding)
Control blood pressure

Question 14

What are some consequences of stroke

Answer 14

Dysphagia, dysphasia

Loss of limb movement

Question 15

What is a transient ischaemic attack TIA

Answer 15

like a warning stroke,

Last <24 hours