Stroke Flashcards
3 features of total anterior circulation stroke (TACS)
Hemiplegia involving at least two of face, arm and leg with maybe hemisensory loss
Homonomous hemianopia
Cortical signs (dysphasia, neglect)
What arteries are affected in TACS?
Anterior and middle cerebral arteries
Features of partial anterior circulation stroke and how many features you need for it?
2 of 3 of Hemiplegia involving at least two of face, arm and leg with maybe hemisensory loss
Homonomous hemianopia
Cortical signs (dysphasia, neglect)
OR
Isolated cortical dysfunction e.g. dysphasia
OR
Pure motor/sensory signs less severe than in lacunar stroke
Where do lacunar infarcts commonly occur?
Deeper parts of the brain (basal ganglia, thalamus, white matter) and brain stem
What are the features of lacunar stroke?
Purely hemiplegia or sensory problems in any two of face, arm and leg. OR Sensorimotor stroke OR Ataxic hemiparesis
No impact on higher cortical functions.
Signs and symptoms of posterior circulation stroke (POCS) - there’s a lot
Cranial nerve palsies Bilateral motor and/or sensory deficits Conjugate eye movement disorders Isolated homonymous hemianopia Cortical blindness Cerebellar deficits without ipsilateral motor/sensory signs
What do dominant and non-dominant hemisphere strokes affect?
Dominant - language
Non-dominant - spatial awareness e.g. neglect
What is leukoaraiosis (occurs in white matter disease)?
Generally patchy shadowing around the ventricles on CT
Where does arterial dissection occur to cause stroke and what is the management?
Vertebral or carotid arteries
Antiplatelets and anticoagulation
For primary intra-cranial haemorrhage, what causes lobar and what causes deep haemorrhage?
Lobar - amyloid angiopathy.
Deep - blood pressure
What is the ABCDD of medical stroke prevention?
Antithrombotic therapy (antiplatelet and/or anticoagulant) Blood pressure Cholesterol Diabetes Don't smoke
Basically same as cardiovascular risks.
For antihypertensive use in stroke, do they need to be hypertensive to give them antihypertensives?
No they benefit normotensive patients as well.
What is the main complication of carotid endarterectomy?
Stroke