Stroke Presentation and Investigation Flashcards
What are the symptoms of a stroke?
Loss of power
Loss of sensation
Loss of speech – loss of comprehension or loss of ability
Loss of vision
Loss of coordination
What are the essential things to ask about when taking a history?
Time of onset
Witnesses
Headache, vomiting, neck stifness, photophobia
Loss of consciousness
Fit
Incontinence
What is the neurological history likely to be?
Motor (clumbsy or weak limb)
Sensory (loss of feeling)
Speech (dysarthia - unclear articulation of speech that is otherwise linguistically normal) Dysphasia (deficiency in the generation of speech, and sometimes also in its comprehension)
Neglect / visospatial problems
Vision: Loss in one eye or hemianopia (blindness over half the field of vision). Gaze palsy (symmetric limitation of the movements of both eyes in the same direction)
What are the causes of stroke?
- Blockage of a vessel with thrombus or clot
- Disease of vessel wall
- Disturbance of normal properties of blood
- Rupture of vessel wall
–(haemorrhage)
Damage to part of the brain due to blockage of a blood vessel by thrombus or embolus (85% infarction)
Or due to haemorrhage from rupture of a blood vessel (15% haemorrhage)
Look at the different arteries
What part of the brain does the carotid system supply?
The carotid system supplies most of the hemispheres and cortical deep white matter
What does the vertebro-basilar system supply?
Brainstem
Cerebellum and occipital lobes
What is the motor cortex responsible for?
Movement
What is the frontal lobe responsible for?
Judgement, foresight and voluntary movement.
Smell
What is Broca’s arch responsible for?
Speech
What is the temporal lobe responsible for?
Intellectual and emotional functions
What is the brainstem responsible for?
Swallowing, breathing, heartbeat, wakefulness centre and other involuntray functions
What is the cerebellum responsible for?
coordination
What is Wernicke’s area responsible for?
SPeech comprehension
What is the occipital responsible for?
Primary visual area