Stroke Flashcards
What is the ABCD2 score
used to predict likelihood of stroke following TIA Age >60 BP >140/90 Clinical features Duration Diabetes
what is the full work up when it comes to stroke
Type of stroke
Size of stroke
Laterality of stroke
Cause of stroke
What is the first line investigation for suspected stroke
CT non-contrast
How does a haemorrhagic stroke appear on CT
bright white
How does an ischaemic stroke appear on CT
dark spot
what is TACS
total anterior circulation syndrome
what are the features of TACS
hemiplegia of face, arm, leg
homonymous hemianopia
higher cerebral dysfunction
what is PACS
partial anterior circulation syndrome
what are the features of PACS
2/3 of TACS features
OR isolated cortical dysfunction
OR pure motor/sensory signs
What is LACS
lacunar syndrome
what are features of LACS
affects 2 of: face, arm, leg
pure sensory OR motor loss
What metabolic conditions are associated with LACS
HTN
DM
^ cholesterol
what is POCS
posterior circulation syndrome
what are the features of POCS
CN palsies BILATERAL sensory +/or motor deficits isolated homonymous hemianopia conjugate eye movement disorders cortical blindness cerebellar deficits (DANISH)
which cerebral hemisphere is dominant in most people
left
what does damage to the dominant hemisphere usually affect
language
what does damage to the non-dominant hemisphere usually affect
spatial awareness
what are causes of stroke
atherothromboembolic
cardioembolic
small vessel disease
other
what is the most common atherothromboembolic cause of stroke
carotid artery disease
atherothromboembolism is a white/red plaque and is platelet/fibrin rich
white plaque
platelet rich
what is the most common cardioembolic cause of stroke
atrial fibrillation
cardioembolism is a white/red plaque and is platelet/fibrin rich
red plaque
fibrin rich
what medication is used for atherothromboembolism
antiplatelet
what medication is used for cardioembolic stroke
anticoagulant
what can haemorrhagic stroke be divided into
primary and secondary intracerebral haemorrhage
causes of primary intra cerebral haemorrhage
hypertension - deeper
amyloid angiopathy - peripheral
causes of secondary intra cerebral haemorrhage
ateriovenous malformation
aneurysm
tumour
others
what is the ABCDD of stroke prevention
anti thrombotic therapy blood pressure cholesterol diabetes dont smoke
what is the CHA2DS2VASc score
used for determining whether AF patients need anticoagulation
what is the HAS-BLED score
bleeding risk - to identify reversible risk factors for anticoagulation
Acute management of ischaemic stroke
ABCDE
CT/MRI
thrombolysis <4.5 hours of symptom onset
thrombectomy <6 hours of symptom onset
antiplatelets within 24 hours - aspirin 300mg + PPI for 2 weeks
Acute management of haemorrhagic stroke
ABCDE
CT/MRI
control BP
reverse anticoagulation
what is Weber’s syndrome
midbrain stroke syndrome
crossed over findings
