Stroke and TBI Flashcards
Define stroke
A clinical syndrome of presumed vascular origin characterised by rapidly developing signs of focal or global disturbance of cerebral functions which lasts longer than 24 hours or leads to death
A stroke happens when what?
- blood supply to brain is cut off (ischaemia)
OR - there is bleeding around the brain (haemorrhage)
What is ischaemia?
a physical interruption of blood flow in a vessel
What is an infarct?
the area of ischaemia
What are the different types of stroke and their commonness?
- ischaemic (85%)
- haemorrhagic stroke (15%)
- transient ischaemic attack (TIA)
What is an ischaemic stroke?
an artery supplying blood to the brain is blocked by a clot
What is a haemorrhagic stroke?
a blood vessel ruptures in the brain, causing bleeding in the brain
What is a transient ischaemic attack?
- temporary interruption of blood flow due to a clot
- resolves quickly
- stroke symptoms occur but usually last less than 24 hours
What are the subtypes of ischaemic strokes?
- large vessel disease
- small vessel disease
- embolic
- cryptogenic
What is large vessel disease?
An ischaemic stroke due to plaque and thrombus that forms in the blood vessel
What is small vessel disease?
An ischaemic stroke due to hypertension, ageing, genetics
What is an embolic stroke?
An ischaemic stroke due to a clot travelling to the brain - common after heart surgery
What is a cryptogenic stroke
Cause not determined
What are the subtypes of haemorrhagic stroke?
- intracerebral haemorrhage
- subarachnoid haemorrhage
What is an intracerebral haemorrhage?
bleeding into the brain tissue
What is a subarachnoid haemorrhage?
Bleeding into the space under the arachnoid mater
What is the effect of an ischaemic stroke on the brain?
- neurons are starved of oxygen
- infarct sizes vary depending on which blood vessel is blocked
What is the effect of a haemorrhagic stroke on the brain?
- neurons are disrupted by direct contact with blood
- their extracellular balance is disturbed and they become dehydrated
What us a lesion?
an area of damaged tissue
What does TACI stand for?
total anterior circulation infarct
What is a TACI?
the worst type if ischaemic stroke affecting the entire anterior circulation of one side of the brain
How common is a TACI?
most common - 70%
Which arteries are usually affected by a TACI?
- middle cerebral artery (90%)
- anterior cerebral artery (2%)
What lobes are affected by a TACI?
frontal, parietal, one side temporal
What cortices are affected by a TACI?
motor, somatosensory, language
What are the symptoms of a TACI?
combination of:
1. unilateral and contralateral motor and/or sensory deficit of at least 2 out of arm leg and face
2. new higher order dysfunction
3. homonymous visual field deficit