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Neurology > Stroke > Flashcards

Stroke Flashcards

1
Q

What are the different types of strokes?

A

Haemorrhagic = structural abnormality, hypertensive, amyloid angiopathy
Infarct = atheroembolic, small vessel, cardioembolic, other
Subarachnoid haemorrhage

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2
Q

What imaging modality is used to diagnose strokes?

A

CT scans

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3
Q

What are the different classifications of stroke?

A

POCI, LACI, TACI, PACI

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4
Q

What are the symptoms of total anterior circulation syndrome (TACS)?

A

Hemiplegia involving at least two of face, arm and leg
Hemisensory loss
Homonymous hemianopia and cortical signs

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5
Q

What is the prognosis of total anterior circulation syndrome (TACS)?

A

Most severe type of stroke = only 5% alive and independent at one year

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6
Q

What are the symptoms of partial anterior circulation syndrome (PACS)?

A

2 out of 3 features present in a TACS or isolated cortical dysfunction or pure motor/sensory signs less severe than in lacunar syndromes

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7
Q

What is the prognosis of partial anterior circulation syndrome (PACS)?

A

About 55% alive and independent at 1 year

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8
Q

What are lacunar infarcts?

A

Small infarcts in deeper parts of the brain and in the brainstem

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9
Q

What causes lacunar syndrome (LACS)?

A

Occlusion of a single deep penetrating artery

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10
Q

What parts of the body are affected by lacunar syndrome (LACS)?

A

Any two of the face, arms or legs

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11
Q

What is the prognosis of lacunar syndrome (LACS)?

A

Best prognosis of all strokes = 60% alive and independent at 1 year

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12
Q

What are the symptoms of posterior circulation syndrome (POCS)?

A

Cranial nerve palsies, bilateral motor and/or sensory deficits and cerebellar deficits without ipsilateral motor/sensory signs

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13
Q

What are the ocular symptoms of posterior circulation syndrome (PCOS)?

A

Conjugate eye movement disorders, isolated homonymous hemianopia, cortical blindness

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14
Q

What is the prognosis of posterior circulation syndrome (PCOS)?

A

About 60% are alive and independent at 1 year

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15
Q

What do dominant (left) hemisphere cortical events impact?

A

Affect language = huge implications for rehab

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16
Q

What do non-dominant (right) hemisphere cortical events impact?

A

Affect spatial awareness

17
Q

What are the causes of ischaemic disease?

A

Atherothromboembolism (50%), intracranial small vessel disease (25%), cardiac source of embolism (20%), rare causes (5%)

18
Q

What are the causes of intracranial small vessel disease?

A

Ischaemic stroke (80%), primary intracerebral haemorrhage (15%), subarachnoid haemorrhage (5%)

19
Q

What are types 1-3 of small vessel disease?

A 
1 = arteriosclerotic
2 = sporadic + hereditary cerebral amyloid angiopathy
3 = genetic small vessel disease
20
Q

What is type 1 small vessel disease related to?

A

Age and risk factor related = fibrinoid necrosis, lipohyalinosis, microatheroma, microaneurysm

21
Q

What are types 4-6 of small vessel disease?

A 
4 = inflammatory and immunologically mediated
5 = venous collagenosis
6 = other small vessel disease
22
Q

How does atrial fibrillation impact the likelihood of strokes?

A

5x increased risk of stroke if patient has AF

1 in 6 strokes are due to AF

23
Q

What are the causes of primary intracerebral haemorrhage?

A

Hypertension (deep haemorrhage) and amyloid angiopathy (lobar haemorrhage)

24
Q

What are the causes of secondary intracerebral haemorrhage?

A

Arteriovenous malformations, aneurysms or tumours

25
Q

What is the ABC of stroke prevention?

A

Antithrombotic therapy
Blood pressure
Cholesterol
Diabetes and don’t smoke

26
Q

What is the maximum score on the CHA2DS2-VaSc score?

A

9 = stroke and age >=75 get 2 points each, all others get 1 point

27
Q

What are the other criteria on the CHA2DS2-VaSc?

A

Congestive heart failure, hypertension, diabetes, vascular disease, age 65-74, female

28
Q

What did the PROGRESS study show?

A

Perindopril reduces the relative risk of stroke

29
Q

What does low cholesterol increase the risk of?

A

Haemorrhagic stroke

30
Q

What is the benefit of performing a carotid endarterectomy?

A

Reduces recurrent stroke risk at 2 years by 65%

31
Q

What morbidities occur after a stroke?

A

Dysphagia, malnutrition and dehydration

32
Q

When should patients with an acute stroke have their hydration assessed?

A

Within 4hrs of arrival

33
Q

What is the treatment of an acute ischaemic stroke?

A

IV tPA = must be given < 4.5 hrs after symptom onset

34
Q

What are the two acute treatments for strokes?

A

Thrombolysis and thrombectomy

35
Q

What type of clot is thrombectomy used for?

A

Treating proximal clots with evidence of necrosis

36
Q

What is the treatment if the NIHSS is <=3?

A

Aspirin and clopidogrel for up to three weeks

Neurology (48 decks)

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