Stroke ; Lecture Flashcards
What is the World Health Organization (WHO) definition of stroke?
A clinical syndrome characterized by rapidly developing signs of focal (or global) disturbance of cerebral function lasting >24 hours or leading to death, with no apparent cause other than vascular origin.
A transient ischemic attack (TIA) is defined as neurological symptoms lasting _________ with no evidence of infarction on imaging.
<24 hours.
True/False: Stroke is the second leading cause of death worldwide.
True
Match the stroke subtype with its description:
Ischemic stroke.
Hemorrhagic stroke.
TIA.
Ischemic stroke: Caused by arterial occlusion.
Hemorrhagic stroke: Bleeding into brain tissue or subarachnoid space.
TIA: Temporary focal neurological symptoms with no infarction.
Name five modifiable risk factors for stroke.
Hypertension.
Diabetes mellitus.
Smoking.
Hyperlipidemia.
Atrial fibrillation.
_________ is the single most important modifiable risk factor for stroke.
Hypertension.
True/False: Age, male gender, and a family history of stroke are non-modifiable risk factors.
True.
What are the two main mechanisms of ischemic stroke?
Embolism (e.g., from the heart in AF).
Thrombosis (e.g., large artery atherosclerosis).
In hemorrhagic stroke, bleeding causes _________, which leads to increased intracranial pressure and subsequent neurological damage.
mass effect.
True/False: The ischemic penumbra is the area of potentially salvageable tissue around the infarct core.
True.
What are common symptoms of stroke based on vascular territory?
MCA stroke: Hemiparesis, aphasia, neglect.
ACA stroke: Leg weakness, abulia.
PCA stroke: Visual field defects.
Basilar artery stroke: Locked-in syndrome.
Dysphasia occurs in _________ hemisphere strokes, while neglect is more common in _________ hemisphere strokes.
dominant; non-dominant.
True/False: Sudden onset severe headache is a hallmark of ischemic stroke.
False (suggests hemorrhagic stroke or SAH).
What is the first-line imaging modality for stroke?
Non-contrast CT brain.
MRI with _________ is highly sensitive for detecting acute ischemic changes.
diffusion-weighted imaging (DWI).
True/False: A CT angiogram (CTA) can identify large vessel occlusions and guide thrombectomy decisions.
True.
What are the acute treatments for ischemic stroke?
IV thrombolysis with alteplase (if within 4.5 hours).
Endovascular thrombectomy (for large vessel occlusions up to 24 hours).
Aspirin 300 mg (after exclusion of hemorrhage).
Hemorrhagic stroke management focuses on _________ control and reducing _________ pressure.
blood pressure; intracranial.
True/False: Anticoagulation is contraindicated in hemorrhagic stroke.
True.
What secondary prevention strategies are used after a stroke?
Antiplatelets (e.g., aspirin, clopidogrel).
Blood pressure control.
Statins.
Lifestyle modification (e.g., smoking cessation, diet).
What are common complications of stroke?
Aspiration pneumonia.
DVT/PE.
Pressure ulcers.
Post-stroke depression.
Seizures.
The risk of recurrence is highest in the first _________ days after a stroke.
30
True/False: Early rehabilitation improves outcomes in stroke patients.
True.
A 65-year-old man presents with right-sided weakness, slurred speech, and facial droop. Non-contrast CT shows no bleed. What is the next step?
Consider thrombolysis if within 4.5 hours and no contraindications.
A 50-year-old woman presents with sudden severe headache, vomiting, and neck stiffness. CT shows blood in the subarachnoid space. What is the likely diagnosis?
Subarachnoid hemorrhage (SAH).
