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Cardiovascular System > Stroke Pathology and Clinical Assessment > Flashcards

Stroke Pathology and Clinical Assessment Flashcards

1
Q

Stroke

A

Neurological deficit of sudden onset and vascular origin that lasts more than 24 hours

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2
Q

Transient ischaemic attack

A

Same as stroke but lasts less than 24 hours

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3
Q

Stroke symptoms include loss of

A

Power, sensation, speech, vision, coordination

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4
Q

Neurological history/examination findings

A 
Motor and sensory weakness
Dysarthria/dysphasia 
Neglect/visuospatial problems
Vision loss in one eye or hemianopia
Gaze palsy
Ataxia/vertigo/incoordination/nystagmus
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5
Q

Causes of stroke

A

Thrombus/embolism causing blockage of a blood vessel
Haemorrhage from rupture of blood vessel
Disease of vessel wall
Disturbance of normal properties of blood

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6
Q

What brain arteries make up the Circle of Willis

A

Posterior, middle and anterior cerebral arteries
Internal carotid artery
Posterior and anterior communicating arteries

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7
Q

Anterior cerebral artery supplies

A

Front of brain

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8
Q

Posterior cerebral artery supplies

A

Back of brain

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9
Q

The carotid system supplies

A

Most of the hemispheres and cortical deep white matter

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10
Q

The vertebro-basilar system supples

A

Brain stem, cerebellum and occipital lobes

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11
Q

Carotid system contains which arteries

A

Internal carotid, common carotid, anterior and middle cerebral

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12
Q

Vertebro-basilar system contain which artieres

A

Posterior cerebral. basilar, vertebral, cerebellar

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13
Q

Lobes of the brain

A

Temporal, frontal, parietal, occipital

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14
Q

Brain stem function

A

Swallowing, breathing, heartbeat, wakefulness centre, other involuntary functions

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15
Q

Cerebellum function

A

Coordination

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16
Q

Anterior brain functions

A

Speech, smell, judgement, foresight, voluntary movement

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17
Q

Middle brain functions

A

Movement, intellectual and emotional functions, pain, heat and other sensations, hearing

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18
Q

Posterior brain functions

A

Comprehension of language, visual, speech comprehension

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19
Q

Why will small stroke in internal capsule or brain stem result in a major deficit

A

Fibres packed closely together

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20
Q

What percentage of stroke are caused by haemorrhage

A

15%

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21
Q

What percentage of stroke are caused by infarction

A

85%

22
Q

Commonest cause of cardioembolic stroke

A

Atrial fibrillation

23
Q

Lacunar stroke

A

Stroke in small vessels of brain - deep white matter

24
Q

Lacunar stoke is caused by

A

Ischaemia

25
Q

Conditions that can lead to lacunar stroke

A

Hypertension

Diabetes

26
Q

Rarer cause of stroke

A

Carotid dissection

27
Q

Carotid dissection can be caused by

A

Idiopathic

Trauma

28
Q

Locked-in syndrome

A

Patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in body apart from vertical eye movement and blinking

29
Q

Ischaemic stroke causes

A 
Large artery atherosclerosis
Cardioembolic
Small artery occlusion
Undetermined/cryptogenic
Atrial dissection
Venous sinus thrombosis
30
Q

Haemorrhagic stroke causes

A

Primary intracerebral haemorrhage

Secondary haemorrhage - subarachnoid or arteriovenous malformation

31
Q

Cortical stroke

A

Stroke involving the cortex

32
Q

Advantages of localisation of stroke

A

Confrims diagnosis
Selection of imaging
Indicates cause and prognosis

33
Q

Most common imaging method for stroke

A

MRI scan

34
Q

TACS

A

Total anterior circulation stroke

35
Q

PACS

A

Partial anterior circulation stroke

36
Q

LACS

A

Lacunar stroke

37
Q

POCS

A

Posterior circulation stroke

38
Q

Usual visual defect in stroke

A

Homonymous hemianopia

39
Q

TACS makes up what percentage of strokes

A

20%

40
Q

Cause of TACS

A

Occlusion of proximal middle cerebral artery or internal carotid artery

41
Q

Symptoms of TACS

A

Weakness
Sensory deficit
Homonymous hemianopia
Higher cerebral dysfunction - dysphasia/dyspraxia

42
Q

PACS makes up what percentage of strokes

A

35%

43
Q

PACS affects

A

One side of the brain

44
Q

Symptoms of PACS

A

Partial motor and sensory deficit in one side, 2/3 body areas
Higher cerebral dysfunction - dysphasia, visuospatial disturbances
Homonymous hemianopia

45
Q

LACS makes up what percentage of strokes

A

20%

46
Q

Different types of LACS

A

Pure motor
Pure sensory
Sensorimotor

47
Q

Pure motor LACS

A

Complete or incomplete weakness of 1 side, 2/3 body areas

48
Q

LACS are under diagnosed because

A

They are often silent

49
Q

POCS makes up what percentage of strokes

A

25%

50
Q

POCS affect

A

Brainstem, cerebella or occipital lobes

51
Q

POCS symptoms

A 
Bilateral motor/sensory deficit
Disordered conjugate eye movement
Coma
Vertigo
Disordered breathing
Homonymous hemianopia
Nerve palsy
Tinnitus
Horner's syndrome
52
Q

Risk factors for stroke

A 
Hypertension
Atrial fibrillation 
Age
Race
Family history

Cardiovascular System (27 decks)

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