Stroke Presentation Flashcards

1
Q

what is the definition of a stroke

A

neurological deficit

  1. of sudden onset
  2. lasting more than 24hrs
  3. of vascular origin
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2
Q

what are the 5 symptoms of stroke?

A

loss of

  1. power
  2. speech
  3. vision
  4. coordination
  5. sensation
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3
Q

what are the two types of stroke

A
  1. heamorrhagic (rupture of blood vessel)

2. ischaemic (blockage of a blood vessel)

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4
Q

what areas does the carotid blood system supply

A

most of the hemispheres and cortical deep white matter

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5
Q

what areas does the vertebro-basilar blood system supply

A

cerebellum and occipital lobes

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6
Q

what is another name for a stroke that occurs in the deep white matter

A

lacunar stroke

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7
Q

define a Total anterior circulation stroke (TACS)

A

large cortical stroke in middle/anterior cerebral artery

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8
Q

define a Partial anterior circulation stroke (PACS)

A

cortical stroke in middle/anterior cerebral artery areas

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9
Q

if a patient has had a TACS what symptoms may they present with (4)

A

weakness
sensory deficit
loss of vision
higher cerebral dysfunction

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10
Q

if a patient has had a PACS (most common type) what symptoms may they present with

A

weakness
sensory deficit
restricted movement e.g in one limb
loss of vision

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11
Q

what is the most common lacunar stroke

A

pure motor

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12
Q

what investigations would you do for a stroke

A
full blood count 
CT scan
MRI scan 
Carotid doppler
(sometimes Echo - can be helpful in looking for clots in the heart)
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13
Q

what is the difference between a stroke and a TIA

A

in a TIA symptoms will resolve within 24hrs

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14
Q

what type of stroke is the most common

A

PACS-partial anterior circulation stroke 35%

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15
Q

what type of stroke has the highest mortality at 1 year

A

TACS 60% at 1 year

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16
Q

what are 2 modifiable risk factor for stroke

A

high blood pressure

atrial fibrilation

17
Q

what are 3 non-modifiable risk factors for stroke

A

age
race
family history

18
Q

what are the investigations for stroke

A

Blood tests
ECG
CT
MRI

19
Q

an echo can be a useful investigation in stroke, why

A

useful to look for clots in the heart

20
Q

what are the main differences between CT and MRI

A

CT:
quick
shows up blood

MRI:
takes up to 30 mins
claustrophobic
shows up ischaemic stroke better

21
Q

discuss secondary prevention of stroke

A
vascular risk factor are identified:
smoking 
hypertension
hyperlipidemia
diabetes mellitus 

and managed appropriately

22
Q

what are the causes of stroke

A

blockage of a vessel with thrombus or clot

disease of vessel wall

disturbance of normal blood properties

rupture of vessel wall-haemorrhage

23
Q

what is the commonest cause of a cardioembolic stroke

A

atrial fibrillation

24
Q

what is a rare cause of stroke

A

carotid dissection this can happen in trauma or be idiopathic

(remember the dentist with locked in syndrome)

25
what is the general drug treatment for stroke
clopidogrel or Aspirin statin blood pressure drugs
26
which patients would qualify for an endarterectomy
with 50-70% stenosis