Stroke (Cerebrovascular)

Question 1

Dysarthria: what is it?

Symptoms?

Answer 1

Disruption of speech output
Typically Neurologic in Nature
Slurred speech, poor articulation,
Langage not affected

Question 2

Dysphasia: what is it?
nature?
how mamy types?

Answer 2

Language disturbances, content of speech affected
Always Neurological, localises to the dominant cerebral hemisphere (usually left).
2 types - fluent and non-fluent

Question 3

Fluent Dysphasia

Answer 3

Repetitive Aphasia - impairment with input and reception of language, difficulty comprehensing verbal words, pharases and sentences.

Wernicke’s Aphasia

Question 4

Non- fluent Dysphasia

Answer 4

Expressive Aphasia - diificulties articulating but
relatively good auditory comprehension

Broca’s Aphasia

Question 5

Causes of Dysarthria - 7 types

Answer 5

Myopathic - muscles of speech
Myaesthenic - Motor end plate
Bulbar - Brainstem
Scanning - cerebellum 
Spastic (pseudo-bulbar) - pyramidal tracts
Parkinsonian - basal ganglia
Dystonic - Basal ganglia

Question 6

Dysarthria: what part of speech is affected by
UMN lesions of cranial nerves,
extrapyrimidal conditions,
cerebellar lesions

Answer 6

Disturbances to the rhythm of speech

Question 7

What is the risk Stratification of Suspected TIA’s?

prognostic score

Answer 7

ABCD^2: (>/=4: high risk)(<4: low risk)

Age > 60     1 point
BP > 140/90 mmHg     1 point
Clinical fx (Unilateral weakness - 2pts; Speech impairment without weakness - 1pt)
Duration (>60mins - 2pts; 10-59mins - 1pt)
Diabetes     1 point

Question 8

Investigations for TIA?

Answer 8

Blood tests
Brain Imaging - CT scan to rule out haemorrhage and stroke mimics
MRI - Diffuse Weighted Imaging
Carotid Duplex Doppler: look for embolus in carotids
Echo - look for embolus in cardiac
ECG

Question 9

What MUST you consider with sudden onset of focal neurological signs and symptoms?

Answer 9

Acute stroke. immediately send to hospital via ambulance

Question 10

Clinical factors suggestive of stroke

6 reasons

Answer 10

Vascular risk factors
Signs of vascular disease
Exact time of onset elicited
Focal Neurological signs 
Deficit that can be easily classified into OCSP subgropu
Severe neurological impairments