STROKE Flashcards
what is the definition of a stroke?
“a clinical syndrome characterised by the rapid onset of focal or global cerebral deficit lasting more than 24 h or leading to death with no other apparent cause than a vascular one”
what percentage of strokes are ischaemic vs. haemorrhagic?
85% - 15%
are strokes more common in men or women?
Men
What subsets of populations are at increased risk of stroke?
afro-americans and hispanics
name 6 major stroke risk factors…
hypertension stress arrhythmias e.g. AF cholesterol hyperglycaemia coagulation disorders
what is the most common cause of ischaemic stroke?
carotid atherosclerosis
thrombolysis reduces the size of the ischaemic penumbra and core, true or false?
FALSE
only reduces size of penumbra
excitotoxicity involves over activation of which receptors?
glutamate NMDA receptor
following a stroke, what is the acute phase response?
chemokines cross BBB and migrate to liver > t cell/neutrophil release from thymus/bone marrow > t cells/neutrophils cause post infarct neurotoxicity
what are the three stages of pos-infarct recovery?
acute injury
vascular responses + inflammation
plasticity
what are the 3 endogenous repair mechanisms designed to heal damaged neural tissue?
glial scarring
angiogenesis
neurogenesis
what are the two main sites of neurogenesis in the adult brain?
Subgranular zone
Subventricular zone
which neurotoxic cytokine is released by microglia in response to ischaemia?
IL1
what is reperfusion injury?
restriction of blood supply in response to toxic metabolite release from ischaemic core
what is the name of the factor that, when released in response to damaged cerebral endothelium, stimulates angiogenesis?
VEGF
glial cell activation in the recovery phase stimulates release of which neurogenesis stimulating cytokine?
IGF1
what is the threshold for carotid stenosis endoarthectomy?
50% occlusion
what drugs are used in the treatment of secondary prevention of stroke?
aspirin and statins
what is the difference between stroke and TIA?
Symptoms completely resolve within 24 hours
what is a lacunar stroke?
stroke resulting from the occlusion of small penetrating arteries that supply deep structures of the brain. Likely to be artherothrombotic as opposed to emboli
the mediate striate artery is a branch of which cerebral artery?
anterior cerebral
which way does the toe move in a positive babinski’s relfex?
big toe extension
occurs in the absence of descending inhibition
following a stroke, what is the most common gait you will see?
hemiplegic
spasticity in flexors of arms and extensors of foot due to pyramidal lesion
