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Cardiovascular > Stroke - Presentation and Investigation > Flashcards

Stroke - Presentation and Investigation Flashcards

1
Q

What is a stroke?

A

Neurological deficit of sudden onset lasting more than 24hrs

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2
Q

What are the symptoms of stroke?

A 
Loss of power 
Loss of sensaation 
Loss of speech 
Loss of vision 
Loss of coordination
Headache 
Vomiting 
Neck stiffness
Photophobia
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3
Q

What causes a stroke?

A

Blockage of a vessel with thrombus or clot
Disease of vessel wall
Disturbance of normal properties of blood
Rupture of vessel wall - haemorrhage

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4
Q

What are the three types of blood supply to the brain?

A

Anterior circulation
Posterior circulation
Circle of Willis

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5
Q

How much of stroke is caused by infarction or haemorrhage?

A

85% infarction

15% haemorrhage

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6
Q

What are some causes of ischaemic stroke?

A 
Large artery atherosclerosis 
Cardioembolic 
Small artery occlusion 
Cryptogenic 
Arterial dissection 
Venous sinus thrombosis
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7
Q

What are the causes of haemorrhage stroke?

A

Primary intracerebral haemorrhage

Secondary haemorrhage

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8
Q

What are some types of secondary haemorrhage?

A

Subarachnoid haemorrhage

Arteriovenous malformation

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9
Q

What is the commonest cause of cardioembolic stroke?

A

Atrial fibrillation because clot forms in the heart which then moves up to the brain

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10
Q

What is a carotid dissection?

A

When the wall of the carotid artery tears and a clot forms. The clot then breaks off and moves to block a vessel in the brain

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11
Q

What are the 4 stroke subtypes?

A

Total anterior circulation stroke
Partial anterior circulation stroke
Lacunar stroke
Posterior circulation stroke

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12
Q

Why does a TACS take place?

A

Usually due to occlusion of the proximal middle cerebral artery or the internal cerebral artery

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13
Q

What is the affect of a TACS?

A

Weakness
Sensory deficit
Homonymous hemianopia
Higher cerebral dysfunction

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14
Q

Why does a PACS take place?

A

Occlusion of branches of the middle cerebral artery

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15
Q

What is the affect of a PACS?

A

Restricted motor and sensory deficit, for example one limb, face and hand dysfunction or higher cerebral dysfunction

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16
Q

What is the affect of a LACS?

A

Pure motor dysfunction - complete or incomplete weakness of 2 side
Pure sensory dysfunction
Sensorimotor dysfunction
Ataxic hemiparesis

17
Q

Where does a POCS affect?

A

Brainstem
Cerebellum
Occipital lobes

18
Q

What is the affect of a POCS?

A 
Bilateral motor/ sensory deficit 
Isolated homonymous hemianopia 
Ipsilateral cranial nerve palsy 
Coma 
Disordered breathing 
Tinnitus 
Vertigo 
Horner's
19
Q

What has to be done to investigate for stroke?

A 
Full blood count 
ECG 
CT 
MRI 
Carotid doppler 
Echocardiogram
20
Q

What does MRI show better than CT?

A

Ischaemic stroke

21
Q

How can you harm someone with a stroke?

A

Cause unexpected bleeding if tissue has established damage

Cause bleeding elsewhere

22
Q

What is the difference between a stroke and a transient ischaemic attack?

A

The transient ischaemic attack lasts less than 24 hours

23
Q

What do the types of symptoms of a stroke victim tell you about their condition?

A

Where the blood clot is

24
Q

What is carotid stenosis?

A

Narrowing or constriction of the inner surface of the carotid artery, usually caused by atherosclerosis.

25
Q

What type of stroke has the highest mortality rate?

A

Total anterior circulation stroke

26
Q

What are the risk factors for stroke?

A 
High blood pressure
Atrial fibrillation 
Age 
Race 
Family history
27
Q

What is thrombolysis?

A

Breaking down a thrombus

28
Q

What should not be used when treating the acute phase of stroke?

A

Streptokinase

29
Q

When can thrombolysis not be done?

A

When a person is older than 80

Usually when a person is younger than 16

30
Q

What are the acute stroke treatments available?

A

Stroke unit
Thrombolysis
Aspirin
Hemicraniectomy

31
Q

Who is at most risk of having a stroke?

A

Patients that have already had a stroke previously

32
Q

What is the most important thing to do to prevent secondary strokes from TIA or minor strokes?

A

Evaluation and initiation of treatment in a specialised outpatient clinic

33
Q

What medication can be used as secondary prevention for stroke?

A

Clopidogrel
Aspirin and dipyridamole
Statin
Blood pressure drugs

34
Q

What is a carotid endarterectomy and why is it done?

A

It is a surgical procedure that corrects stenosis and is done to prevent strokes from happening

Cardiovascular (34 decks)

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