Stroke:pathology and investigation Flashcards

1
Q

What is a stroke?

A

Neurological deficit of sudden onset lasting more than 24 hrs of vascular origin

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2
Q

What is a Transient ischaemic attack?

A

less than 24hrs
neuro deficit
of vascular origin

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3
Q

What are the symptoms of stroke?

A
  • Lose of power
  • Loss of sensation
  • Loss of speech
  • Loss of vision
  • Loss of coordination
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4
Q

What does photophobia suggest?

A

haemorrhage

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5
Q

What is dysarthria

A

the muscles you use for speech are weak or you have difficulty controlling them

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6
Q

What is dysphasia?

A

language disorder marked by deficiency in the generation of speech, and sometimes also in its comprehension, due to brain disease or damage

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7
Q

What is nystagmus?

A

“jiggly eyes” rapid jerking movements

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8
Q

What causes a stroke?

A

Blockage of a blood vessel by thrombus or embolus to brain
OR
due to haemorrhage

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9
Q

What links anterior and posterior circulation of the brain?

A

Circle of Willis

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10
Q

What does the carotid system supply?

A

Most of the hemispheres and cortical deep white matter

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11
Q

What does the vertebro-basilar system supply?

A

Brain stem

cerebellum and occipital lobes

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12
Q

What is frontal lobe responsible for?

A

Judgement
foresight
Voluntary movement

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13
Q

What is Broccas area responsible for?

A

Speech

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14
Q

What is the temporal lobe responsible for?

A

intellectual and emotional functions

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15
Q

What is the brainstem responsible for?

A

Swallowing
Breathing
heartbeat
wakefulness centre and other involuntary functions

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16
Q

What is the cerebellum responsible for?

A

Co-ordination

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17
Q

What is wernicke`s area responsible for?

A

Speech comprehension

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18
Q

What is the occipital lobe responsible for?

A

Primary visual area

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19
Q

What is the temporal lobe also responsible for?

A

Hearing

20
Q

What is the parietal lobe for?

A

Comprehension of language

21
Q

What is the sensory cortex responsible for?

A

Pain heat and other sensations

22
Q

In deep white matter where will a stroke be most devasting and why?

A

The internal capsule
and Pons

Major effect as fibres are packed close together

23
Q

What are the 4 causes of a stroke?

A
  • Blockage of a vessel with clot or thrombus
  • Disease of vessel wall
  • Disturbance of normal properties of blood
  • Rupture of vessel
24
Q

What is the commonest cause of a cardioembolic stroke?

A

Atrial fibrilation

25
Q

What is a small vessel of a stroke called?

A

Lacunar

26
Q

What are the rarer causes of a stroke?

A

Carotid dissection (idiopathic or stroke)

27
Q

What are the subtypes of stroke?

A
  • TACS: Total anterior circulation stroke
  • PACS: Partial anterior circulation stroke
  • LACS: LAcunar stroke
  • POCS:Posterior circulation stroke
28
Q

What does left optic nerve compression result in?

A

Unilateral field loss

29
Q

What does chiasmal compression from pituitary tumour/thrombus

A

Bitemporal hemianopia

30
Q

What does left cerecrovascular event result in?

A

Homonymous hemianopia

31
Q

What percentage of strokes TACS?

A

20%

32
Q

What are the symptoms of a TACS?

A
Weakness 
sensory deficit
Homonymous hemianopia (loss of vision)
Higher cerebral dysfunction (dysphasia, dyspraxia)
33
Q

What is TACS usually caused by?

A

Occulsion of proximal middle cerebral artery or ICA

34
Q

What percentage of strokes are PACS?

A

35%

35
Q

What are the symptoms of a PACS?

A
  • One limb
  • Face and hand
  • higher cerebral dysfunction

(2/3 of the above)

36
Q

What causes PACS?

A

Middle Cerebral Artery

37
Q

What percentage of strokes are LACS?

A

20%

38
Q

What are the four types of LACS?

A
  • Pure motor
  • Pure sensory
  • Sensorimotor
  • Ataxic hemiparesis
39
Q

Describe a pure motor LAC?

A

Complete or incomplete weakness of 1 side, involving the whole of 2 of 3 body areas (face/arm/leg)

40
Q

Describe a pure sensory LAC?

A

Sensory symptoms involving the whole of 2/3 body areas

41
Q

Describe an ataxic hemiparesis LAC?

A

Hemiparesis and ipsilateral cerebellar ataxia
Small infarcts in basal ganglia or pons.
Intrinsic disease of single basal perforating artery (end arteries).

42
Q

What is ataxia?

A

Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that includes gait abnormality.

43
Q

What percentage of strokes are POC`s?

A

25%

44
Q

What is affected during POCs?

A

Brainstem,cerebellar or occipital lobes

45
Q

What is the normal presentation of POCS?

A

There is none
ahahahaha
variable and complex

46
Q

What are the modifiable risk factors for a stroke?

A
  • High blood pressure

- Atrial fibrillation

47
Q

What are the non-modifiable risk factors for stroke?

A
  • Age
  • Race
  • Family history