Stroke Flashcards
define a stroke (cerebrovascular accident CVA)
rapidly developing focal or global loss of brain function lasting >24 hours that is vascular in origin
stroke mimics
seizures
sepsis
SOL
classification of stroke
- haemorrhagic
- infarction
- sub-arachnoid haemorrhage
causes of haemorrhagic stroke
hypertension
amyloid angiopathy
structural abnormality e.g. AV malformation
causes of infarctive stroke
atheroembolic
cardioembolic
risk factors for stroke
previous or TIA MI angina hypertension DM smoking vasculitis OCP
presentation of stroke
Rosier score or FAST tool sudden onset asymmetrical facial, arm and leg weakness dysphasia visual field defect
where is the primary auditory cortex located?
superior temporal gyrus
where is Broca’s area located?
inferior frontal gyrus
where is Wernicke’s area located?
superior temporal gyrus
diagnosis of stroke
CT for quick access and rule out haemorrhage (blood is white due to iron content)
MRI T1/2 or FLAIR for infarction/ old lesions
carotid doppler
management of stroke
aspirin 300mg ASAP after CT (continue for 2 weeks, step-down is clopidogrel)
thrombolysis/ thrombectomy= IV alteplase given as a bolus then IV to dissolve clots
endovascular therapy= interventional radiotherapy to remove clot by catheter or stent
DVT prophylaxis
dysphagia= swallow screen, NG tube, SALT
time frame for administration of thrombolysis/ thrombectomy
4.5 hours
what is a TIA?
transient ischaemic attack is a brief episode of neurological dysfunction lasting <24 hours
management of TIA
immediate therapy with antiplatelets and statins e.g. clopidogrel and atorvastatin
carotid endarterectomy
