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Y4: Neurology > Stroke COPY > Flashcards

Stroke COPY Flashcards

1
Q

What is the definition of a stroke?

A
  • CNS infarction
  • Based on evidence of:
    • Focal ischaemic injury in vascular distribution
    • Clinical evidence
  • With other causes excluded
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2
Q

What happens to the brain when a stroke occurs?

A
  • Blood flow stops
  • Neurones depolarised
    • Onset of early symptoms
  • Brain tissue dies
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3
Q

How can more brain death be prevented in stroke?

A

By restoring the blood flow as soon as possible

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4
Q

Draw a diagram of the circle of willis

A
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5
Q
A
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6
Q
A
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7
Q

If there is right sided body weakness, which part of the brain is affected?

A

Left cerebral hemisphere

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8
Q
A
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9
Q

What will a stroke of the middle cerebral artery cause?

A

Face and arm weakness

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10
Q
A
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11
Q

Where is Brocas area of the brain?

What is its function?

A

Left frontal lobe

Speech production

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12
Q

What is Wernickes area?

What is its function?

A

Posterior superior temporal gyrus

Understanding and producing meaningful speech

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13
Q
A
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14
Q

What visual change would occur with a stroke in this area?

A

Right homonymous hemianopia

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15
Q

If a patient came in with acute light-headedness with past-pointing and nystagmus, where would the stroke be?

A

Cerebellum

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16
Q
A

F.

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17
Q

What is pictured here?

A

Harmorrhagic stroke on the left

Ischaemic stroke on the right

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18
Q

How do you differentiate between different types of stroke?

A

MRI head

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19
Q

What is an ischaemic stroke?

A

Episode of neurological dysfunction caused by an infarction

20
Q

What are some of the causes of ischaemic stroke?

A
  • Cryptogenic
  • Cardiac embolism
  • Small vessel disease
  • Atherosclerotic cerebrovascular disease
21
Q

What are the different categories of stroke under the Oxford community stroke project?

A
  • Total anterior circulation syndrome (TACS)
  • Partial anterior circulation syndrome (PACS)
  • Posterior circulation syndrome (POCS)
  • Lacunar syndrome (LACS)
22
Q

Describe TACS?

A
  • Usually proximal MCA or ICA occlusion
    • Hemiparesis
    • Hemianopia
    • Higher cortical dysfunction
23
Q

Describe PACS?

A
  • MCA branch occlusion
    • Isolated higher cortical dysfunction
    • OR
    • Any 2 of hemiparesis, higher cortical dysfunction, hemianopia
24
Q

Describe POCS?

A
  • Perforating arteries, PCA or cerebellar arteries
    • Isolated hemianopia
    • OR
    • Brainstem syndrome
25
Q

Describe LACS?

A
  • Small vessel disease
    • Pure motor stroke
    • Pure sensorys troke
    • Sensorimotor stroke
    • Ataxia hemiparesis
    • Clumsy hand-dysarthria
26
Q
A
27
Q

What is the definition of an intracerebral haemorrhage?

A

Collection of blood within the brain parenchyma or ventricules that is not caused by trauma.

28
Q

What is the definition of stroke caused by intracerebral haemorrhage?

A

Rapidly developing clinical signs of neurological dysfunction attributable to a focal collection of blood within the brain parenchyma or ventricular system that is not caused by trauma.

29
Q

What are the causes of intracranial bleeds?

A
  • Trauma
  • Tumours
  • Small vessel disease
  • Cocaine / Amphetamines
  • Blood clotting deficiencies
30
Q

Describe the management of an ischaemic stroke?

A
  • Aspirin
  • Stroke unit
  • IV thrombolysis
  • Hemicranectomy
31
Q

Describe the management of an haemorrhagic stroke (due to intracerebral bleed)?

A
  • BP control
  • Stroke unit
  • Neurosurgical evacuation
32
Q

Describe hyper-acute treatments for ischaemic stroke?

A
  • Thrombolysis
    • Within 4 hours of symptom onset
  • Thrombectomy
    • Within 8 hours of symptom onset
  • Stroke unit
    • Prevent aspiration
33
Q

What explains most causes of ischaemic stroke?

A

Cerebrovascular risk factors

34
Q

Name some cerebrovascular risk factors?

A
  • High BP
  • Obesity
  • Smoking
35
Q

Describe potential investigations into stroke?

A
  • CT (1st line)
  • MRI if diagnostic doubt
  • Duplex US of carotid and vertebral arteries
  • Intra-arterial angiography
36
Q

Clinical features of stroke?

A
  • Weakness
  • Speech disturbance
  • Ataxia (if cerebellum involved)
37
Q

Describe an ischaemia stroke?

A
  • Thromboembolic disease
  • Secondary to atherosclerosis in the major extracranial arteries
    • Carotid, aortic arch
38
Q

Describe a haemorrhagic stroke?

A
  • Rupture of a blood vessel within the brain parenchyma
  • Can occur in SAH if the artery ruptures into the brain substance as well as the subarachnoid space
39
Q

Name some structural stroke mimics?

A
  • Cerebral tumours
  • Extradurall/subdural haematoma
  • Cerebral abscess
40
Q

Name some functional stroke mimics?

A
  • Hypoglycaemia
  • Focal seizures
  • Migranous aura
41
Q

What is a TIA?

A
  • Symptoms resolve within 12 hours
  • Includes amaurosis fugax
42
Q

What is a progressive stroke?

A
  • Focal neurological deficit worsens after the patient presents
  • Increasing infarction volume, increasing cerebral blood/oedema
43
Q

What is a completed stroke?

A

Focal deficit persists but does not worsen

44
Q

Management flow chart for stroke

A
45
Q

Management of secondary stroke risk factors

A

Y4: Neurology (11 decks)

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