Stroke

Question 1

What is a CVA?

Answer 1

Cerebrovascular accident

Blood supply to part of the brain is cut off

Question 2

What is a TIA?

Answer 2

Transient ischaemic attack

Similar to stroke but resolves in 24 hours

Question 3

What are the types of stroke?

Answer 3

Ischaemic - thromboembolic

Haemorrhagic

Question 4

What is the urgent investigation if we suspect a stroke?

Answer 4

CT head

Question 5

What are the symptoms of an anterior cerebral artery infarct?

Answer 5

Unilateral contralateral weakness - leg>arm 
Sensory loss
Urinary incontinence
Apraxia 
Dysarthria

Question 6

Why does urinary incontinence occur in an ACA infarct?

Answer 6

Paracentral lobules have a role in voluntary micturition

Question 7

What is apraxia?

Answer 7

Inability to complete motor planning

Question 8

What are the symptoms of a middle cerebral artery infarct?

Answer 8

Contralateral hemiparesis - upperbody/face 
Contralateral hemisensory loss 
Homonymous hemianopia 
Aphasia 
Hemispatial neglect

Question 9

What is a subcortical stroke?

Answer 9

Obstruction of lenticulostriate arteries

Question 10

What are the symptoms of a posterior cerebral artery infarct?

Answer 10

Contralateral homonymous hemianopia with macula sparing

Question 11

What are the symptoms of a cerebellar infarct?

Answer 11

Non-specific symptoms

Ipsilateral cerebellar signs
Ipsilateral brainstem signs

Question 12

What are the symptoms of a brainstem infarct?

Answer 12

Contralateral ascending/descending tract signs

Ipsilateral cranial nerve signs

Question 13

What are the symptoms of a distal basilar infarct?

Answer 13

Visual + oculomotor defects
Behaviour abnormalities
Hallucinations + dreamlike behaviour

Question 14

What are the symptoms of a proximal basilar infarct?

Answer 14

Complete loss of movement
Preserved consciousness
Preserved eye movements

Question 15

What is TACS?

Answer 15

Total anterior circulation stroke

Question 16

What are the signs of a TACS?

Answer 16

All 3

• unilateral weakness of face, arm + leg
• homonymous hemianopia
• higher cerebral dysfunction

Question 17

What is PACS?

Answer 17

Partial anterior circulation stroke

Question 18

What are the signs of a PACS?

Answer 18

2 of

• unilateral weakness of face, arm + leg
• homonymous hemianopia
• higher cerebral dysfunction

Question 19

What is POCS?

Answer 19

Posterior circulation stroke

Question 20

What are the signs of a POCS?

Answer 20

1 of

• cranial nerve palsy + contralateral motor/sensory deficit
• bilateral motor/sensory deficit
• conjugate eye movement disorder
• cerebellar dysfunction
• isolated homonymous hemianopia with macula sparing

Question 21

What is LACS?

Answer 21

Lacunar syndrome

Question 22

What are the signs of a LACS?

Answer 22

1 of

• pure sensory deficit
• pure motor deficit
• sensori-motor deficit
• ataxic hemiparesis

Question 23

What blood vessels are involved in a TACS?

Answer 23

Proximal MCA OR ICA

Question 24

What blood vessels are involved in a PACS?

Answer 24

Branch of MCA

Question 25

What blood vessels are involved in a POCS?

Answer 25

One of

• vertebral
• basilar
• cerebellar
• PCA

Question 26

What blood vessels are involved in a LACS?

Answer 26

Lenticulostriate branches of MCA OR supply to brainstem