Stroke Flashcards
What are the types of stroke?
Total anterior circulation Partial anterior circulation Lacunar Posterior circulation Pontine Cerebellar
What causes a TACS?
25% haemorrhagic
75% ischaemic- cardiac embolus or MCA or ACA occlusion
What are the clinical features of TACS?
All 3 of
- hemiplegia/hemisensory loss
- Homonymous hemianopia
- Higher dysfunction
What higher dysfunction can be seen in TACS?
Left sided= dysphasia
Right sided= agnosia
Visuospatial disturbances, decreased level of conciousness
What are the features of a PACS?
2/3 of
- motor and sentry deficits
- higher dysfunction
- homonymous hemianopia
What causes a lacunar stroke?
Small end artery infarction affecting internal capsule and basal ganglia
What are the types of lacunar stroke?
Pure motor
Pure sensory
Sensory motor
Ataxic hemiparesis
What are the features of a LACS?
Isolated motor and/or sensory deficits with no cortical deficits
- hemiparesis and numbness, ataxic hemiparesis
- no hemianopia, dysphasia, inattention or brainstem signs
What are the features of a POCS?
Involves vertebrobasiliar arteries
Ipsilateral CN III-XII and contralateral motor or sensory loss
Eye movement disorder, Hemianopia, double vision
Cerebellar/brainstem dysfunction
What vessel is affected in a pontine stroke?
Basilar artery
What are the features of a pontine stroke?
Mainly motor and oculomotor signs- contralateral hemiparesis and numbness
N&V, vertigo
Reduced responsiveness
What are the features of a cerebellar stroke?
DANISH Dysdiadokinesia (can't perform fast movements) Ataxia Nystagmus Intention tremor Slurred speech Hypotonia
What investigations are done for a stroke?
FBC, U&Es, ESR, glucose, platelets
Coagulation screen, INR
CT
What bloods are done in a stroke in <55yo?
Autoimmune and thrombophilia screen
What is the emergent management of an ischaemic stroke?
Thrombolysis and thrombectomy in 4.5 hours
Thrombectomy within 6 hours (or 24 if salvageable brain tissue)
Aspirin 300mg within 48 hours
