Stroke Presentation Flashcards
what is the definition of a stroke
neurological deficit
- of sudden onset
- lasting more than 24hrs
- of vascular origin
what are the 5 symptoms of stroke?
loss of
- power
- speech
- vision
- coordination
- sensation
what are the two types of stroke
- heamorrhagic (rupture of blood vessel)
2. ischaemic (blockage of a blood vessel)
what areas does the carotid blood system supply
most of the hemispheres and cortical deep white matter
what areas does the vertebro-basilar blood system supply
cerebellum and occipital lobes
what is another name for a stroke that occurs in the deep white matter
lacunar stroke
define a Total anterior circulation stroke (TACS)
large cortical stroke in middle/anterior cerebral artery
define a Partial anterior circulation stroke (PACS)
cortical stroke in middle/anterior cerebral artery areas
if a patient has had a TACS what symptoms may they present with (4)
weakness
sensory deficit
loss of vision
higher cerebral dysfunction
if a patient has had a PACS (most common type) what symptoms may they present with
weakness
sensory deficit
restricted movement e.g in one limb
loss of vision
what is the most common lacunar stroke
pure motor
what investigations would you do for a stroke
full blood count CT scan MRI scan Carotid doppler (sometimes Echo - can be helpful in looking for clots in the heart)
what is the difference between a stroke and a TIA
in a TIA symptoms will resolve within 24hrs
what type of stroke is the most common
PACS-partial anterior circulation stroke 35%
what type of stroke has the highest mortality at 1 year
TACS 60% at 1 year
what are 2 modifiable risk factor for stroke
high blood pressure
atrial fibrilation
what are 3 non-modifiable risk factors for stroke
age
race
family history
what are the investigations for stroke
Blood tests
ECG
CT
MRI
an echo can be a useful investigation in stroke, why
useful to look for clots in the heart
what are the main differences between CT and MRI
CT:
quick
shows up blood
MRI:
takes up to 30 mins
claustrophobic
shows up ischaemic stroke better
discuss secondary prevention of stroke
vascular risk factor are identified: smoking hypertension hyperlipidemia diabetes mellitus
and managed appropriately
what are the causes of stroke
blockage of a vessel with thrombus or clot
disease of vessel wall
disturbance of normal blood properties
rupture of vessel wall-haemorrhage
what is the commonest cause of a cardioembolic stroke
atrial fibrillation
what is a rare cause of stroke
carotid dissection this can happen in trauma or be idiopathic
(remember the dentist with locked in syndrome)
what is the general drug treatment for stroke
clopidogrel or Aspirin
statin
blood pressure drugs
which patients would qualify for an endarterectomy
with 50-70% stenosis
