Stroke Flashcards
A Rosier score of below 0 indicates what?
Stroke is likely
A Rosier score of above 0 indicates what?
Low likely hood of stroke
What imaging technique is used in the acute phase of stroke treatment?
CT
What imaging technique is used in the chronic phase of stroke treatment?
MRI
85% of strokes are due to….
Infarcts
What are some of the main causes of infarcts?
Atheroemboli
Small Vessel
Cardioembolic
Malignancy
10% of strokes are due to….
Haemorrhagic
What are some of the common causes of haemorrhagic strokes?
Amyloid antipathy
Hypertension
Structural abnormality
5% of strokes are due to….
Sub arachnoid haemorrhage
FAST
Face
Arms
Speech
Time
When can thrombolysis be used?
<4.5 hours since onset of symptoms
What is the drug of choice used in thrombolysis?
tPA
What other rescue therapy is available?
Endovascular therpay
CT angiogram guided catheterisation
In a mild stroke what drugs are used?
Aspirin 300mg
Clopidogrel
Before administering anti platelets what should you know?
You need to wait 24 hours post thrombolysis and a CT to know if there is a bleed or not.
DVT prophylaxis
Intermittent pneumatic compression reduces risk.
Drugs such as heparin needs to be carefully weighed against the risk of bleeding.
TIA
Transient Ischaemic Attack
Brief episode of neurological symptoms
Why are TIAs not considered benign?
Dramatically increased risk of stroke after a TIA
A total Anterior circulation stroke presents with what?
Middle and Anterior cerebral arteries affected.
Higher cerebral dysfunction
Homonymous visual field defects
Contralateral motor and sensory deficit
A posterior stroke presents with what?
Cerebellar dysfunction - DANISH
Isolated homonymous field defects
Cranial nerve dysfunction - brainstem involvement
What is a lacunar stroke?
Purely motor or sensory
What is DANISH - Posterior stroke
Dysdiadochokinesia Ataxia Nystagmus Intention tremor Slurred staccato speech Hypotonia
What is dysdiachokinesia?
Difficulty in performing fast alternating movements e.g
Use door handle
Tap foot rapidly
What are some higher cerebral dysfunctions?
Brocas (Expressive) dysphasia
Wernickes (Receptive) dysphasia
What is expressive aphasia?
Brocas
Difficulty producing coherent speech
What is Wernickes (Receptive) aphasia?
Hard to understand speech or written word.
If someone has Broca’s (expressive) dysphasia which region of the brain is likely to be damaged?
Inferior frontal gyrus
If someone has receptive aphasia which region of the brain is likely to be damaged?
Superior temporal gyrus
Wernickes Aphasia
