Stroke

Question 1

two types of stroke

Answer 1

ischaemic

haemorrhagic

Question 2

causes of haemorrhagic stroke

Answer 2

hypertension

vasculitis, aneurism, arteriovenous malformation

Question 3

what type of thrombus causes ischaemic stroke primarily?

Answer 3

arterial/white thrombus

Question 4

what is the best test to find stroke

Answer 4

CT angio of brain

Question 5

besides CT angio what other tests can be used for stroke

Answer 5

MRI DWI +/- angio

MRI SWI +/- angio

Question 6

true/false - stroke type can be differentiated by history

Answer 6

false - only imaging can determine

Question 7

besides imaging, what other tests can be done for ischaemic stroke

Answer 7

thrombophilia screen, blood glucose and lipid profile
hypertension
any vessel disease suggesting the stroke is not embolic from heart

Question 8

you suspect an embolus/thrombus causing stroke originated from a ruptured plaque. what test do you do?

Answer 8

CT angio of aortic arch and carotids

USS carotids

Question 9

you suspect a cardioembolism caused stroke, what test do you do

Answer 9

ECG for AF or LVH

Question 10

if an older person has a deep haemorrhagic stroke whats the likely cause

Answer 10

hypertension

Question 11

treatment of ischaemic stroke

Answer 11

thrombolysis - up to 4.5 hrs from onset
thrombectomy - 6 hrs from onset of symptoms
thrombectomy is better

Question 12

secondary prevention of stroke if atheroembolic

Answer 12

Aspirin/clopidogrel
statins 
diabetes management 
hypertension management 
lifestyle advice

Question 13

secondary prevention of stoke if cardioembolic

Answer 13

DOAC/Warfarin

Question 14

what is a TIA

Answer 14

transient ischaemic attack
temporary neurological symptoms due to artery occlusion, resolving in <24 hrs
risk of stroke following

Question 15

how is TIA not a full blown stroke

Answer 15

small clot, endothelium secretes TPA to break it down