Stroke presentation & investigation Flashcards
Why is prevention of stroke important to the NHS?
Commonest cause of long term disability in the UK
Patients who’ve had a stroke occupy 20% of NHS beds
Annual cost of over £5 billion treating stroke
What age demographic has the most strokes?
The elderly
Define what a stroke is
Clinical syndrome of sudden onset, causing a neurological deficit (loss of function)
Lasting more than 24 hours or until death
Of Vascular origin
Symptoms of a stroke are defined as being negative symptoms
What does this mean?
Symptoms are more to do with ‘loss of _______’
Symptoms of stroke: Loss of power Loss of speech Loss of sensation Loss of vision Loss of coordination
Describe the clinical signs, on history/examination, that would indicate a stroke
Motor - clumsy/weak
Sensory loss
Speech - Dysarthria/dysphasia
Neglect / visuospatial problems
Vision - loss in one eye or hemianopia
Gaze palsy
Ataxia / vertigo / nystagmus
What is hemianopia?
Blindness over half the field of vision
What is gaze palsy?
Inability to move both eyes in the same direction
What is ataxia?
lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements
What is nystagmus?
Dancing eyes
Rapid fluttery eye movements
What are the 2 types of causes of strokes?
Cerebral infarction
Haemorrhage
What are the 2 artery groups that supply the brain
Vertebral arteries (L & R)
Common carotid arteries (L & R)
What does the common carotid arteries split into?
Internal & external carotid arteries
What is the fate of the vertebral arteries?
Left and right vertebral arteries join together to form the single Basilar artery
What arteries branch off the Basilar artery?
Posterior inferior cerebellar arteries
Superior cerebellar arteries
Posterior cerebral arteries
What arteries make up the circle of willis?
Anterior communicating artery top
Anterior cerebral arteries
Internal carotid arteries/middle cerebral arteries
Posterior communicating arteries
Posterior cerebral arteries bottom
Most cerebral infarctions involve thrombus lodging in what arteries?
Middle cerebral arteries
The brain’s arterial supply can be thought of as an anterior and posterior circulation
What areas of the brain does the carotid system supply?
Anterior
The carotid system (via internal carotid arteries) supplies most of the hemispheres and cortical deep white matter