Stroke Rehabilitation

Question 1

What are the 3 sub-types of stroke?

Answer 1

Intracerebral haemorrhage
Subarachnoid haemorrhage
Infarct

Question 2

How does total anterior circulation syndrome present?

Answer 2

A stroke with hemiplegia, homonymous hemianopia and signs of cortical dysfunction.

Question 3

What is the most severe form of stroke?

Answer 3

Total anterior circulation syndrome

Question 4

What is partial anterior circulation syndrome?

Answer 4

A stroke with 2 of the following:

• Hemiplegia
• Homonymous hemianopia
• Cortical dysfunction

Question 5

Where do lacunar infarcts affect?

Answer 5

Deep brain - may be basal ganglia, thalamus or white matter.

Can also affect brainstem.

Question 6

How does lacunar syndrome present?

Answer 6

Weakness down one-side.

Affects the face, arm or leg.

Question 7

Which form of stroke has the best prognosis?

Answer 7

Lacunar infarct

Question 8

What areas of brain are affected by posterior circulation syndrome?

Answer 8

Brainstem
Cerebellum
Occipital lobes
Parietal lobes

Question 9

How does recovery from stroke take place?

Answer 9

Death of affected tissues with other areas of brain taking over to compensate.

Question 10

What is the dominant hemisphere of the brain in most people?

Answer 10

Left hemisphere

Question 11

What roles are carried out by the right cerebral hemisphere?

Answer 11

Creativity
Music
Spatial orientation
Artistic awareness

Question 12

What roles are carried out by the left cerebral hemisphere?

Answer 12

Spoken language
Reasoning
Number skills
Written language

Question 13

What is commonly responsible for cardioembolic stroke?

Answer 13

Atrial fibrillation

Question 14

How does cardioembolic stroke present?

Answer 14

Multiple clots found in multiple arteries.

Question 15

What is CADASIL?

Answer 15

A genetic condition with increased risk of cerebral amyloid angiopathy.

This leads to strokes.

Question 16

What effect do metallic/prosthetic heart valves have on clot risk?

Answer 16

Increases it.

Question 17

Does a patent foramen ovale decrease stroke risk?

Answer 17

No, it increases it.

Around 25% of the population have a patent foramen ovale.

Question 18

What is carotid artery dissection?

Answer 18

Mechanical tear of the arterial wall, causing a clotting cascade which produces an embolus that can lead to a stroke.

Associated with hypertension.

Question 19

How is carotid artery dissection treated?

Answer 19

Antiplatelets or anticoagulation.

Question 20

What are primary causes of haemorrhagic stroke?

Answer 20

Hypertension
Amyloid angiopathy
Arteriovenous malformation
Aneurysm
Tumour

Question 21

Deep,more central cerebral bleeds are commonly caused by what?

Answer 21

Hypertension

Question 22

Lobular, more peripheral cerebral bleeds are commonly caused by what?

Answer 22

Amyloid angiopathy

Question 23

How is the location of a bleed determined?

Answer 23

MRI scan

Question 24

What does microbleeds from small vessels, as shown by MRI indicate?

Answer 24

Amyloid angiopathy

Question 25

How is intracerebral haemorrhage treated?

Answer 25

Tight blood pressure control.

Question 26

How is stroke prevented?

Answer 26

Antithrombotic therapy
Blood pressure
Cholesterol
Diabetes
Don't smoke

Think ‘ABCDD’.

Question 27

What should be given following an infarct stroke?

Answer 27

Aspirin for 2 weeks then clopidogrel thereafter.

Question 28

What should be given following a cardioembolic stroke?

Answer 28

Anticoagulation therapy.

Question 29

Is the bleeding risk when taking aspirin greater than when taking warfarin?

Answer 29

No, the risk is equal.

Question 30

What is first-line treatment for hypertension?

Answer 30

If over 55, give CCB.

If under 55, give ACE inhibitor.

Question 31

What surgery is used to remove atherosclerosis from those at high-risk of stroke?

Answer 31

Carotid endarterectomy