STROKE

Question 1

what is the definition of a stroke?

Answer 1

“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”

Question 2

what percentage of strokes are ischaemic vs. haemorrhagic?

Answer 2

85% - 15%

Question 3

are strokes more common in men or women?

Answer 3

Men

Question 4

What subsets of populations are at increased risk of stroke?

Answer 4

afro-americans and hispanics

Question 5

name 6 major stroke risk factors…

Answer 5

hypertension
stress
arrhythmias e.g. AF
cholesterol
hyperglycaemia
coagulation disorders

Question 6

what is the most common cause of ischaemic stroke?

Answer 6

carotid atherosclerosis

Question 7

thrombolysis reduces the size of the ischaemic penumbra and core, true or false?

Answer 7

FALSE

only reduces size of penumbra

Question 8

excitotoxicity involves over activation of which receptors?

Answer 8

glutamate NMDA receptor

Question 9

following a stroke, what is the acute phase response?

Answer 9

chemokines cross BBB and migrate to liver > t cell/neutrophil release from thymus/bone marrow > t cells/neutrophils cause post infarct neurotoxicity

Question 10

what are the three stages of pos-infarct recovery?

Answer 10

acute injury
vascular responses + inflammation
plasticity

Question 11

what are the 3 endogenous repair mechanisms designed to heal damaged neural tissue?

Answer 11

glial scarring
angiogenesis
neurogenesis

Question 12

what are the two main sites of neurogenesis in the adult brain?

Answer 12

Subgranular zone

Subventricular zone

Question 13

which neurotoxic cytokine is released by microglia in response to ischaemia?

Answer 13

IL1

Question 14

what is reperfusion injury?

Answer 14

restriction of blood supply in response to toxic metabolite release from ischaemic core

Question 15

what is the name of the factor that, when released in response to damaged cerebral endothelium, stimulates angiogenesis?

Answer 15

VEGF

Question 16

glial cell activation in the recovery phase stimulates release of which neurogenesis stimulating cytokine?

Answer 16

IGF1

Question 17

what is the threshold for carotid stenosis endoarthectomy?

Answer 17

50% occlusion

Question 18

what drugs are used in the treatment of secondary prevention of stroke?

Answer 18

aspirin and statins

Question 19

what is the difference between stroke and TIA?

Answer 19

Symptoms completely resolve within 24 hours

Question 20

what is a lacunar stroke?

Answer 20

stroke resulting from the occlusion of small penetrating arteries that supply deep structures of the brain. Likely to be artherothrombotic as opposed to emboli

Question 21

the mediate striate artery is a branch of which cerebral artery?

Answer 21

anterior cerebral

Question 22

which way does the toe move in a positive babinski’s relfex?

Answer 22

big toe extension

occurs in the absence of descending inhibition

Question 23

following a stroke, what is the most common gait you will see?

Answer 23

hemiplegic

spasticity in flexors of arms and extensors of foot due to pyramidal lesion