Stroke Rehabilitation Flashcards
What are the 3 sub-types of stroke?
Intracerebral haemorrhage
Subarachnoid haemorrhage
Infarct
How does total anterior circulation syndrome present?
A stroke with hemiplegia, homonymous hemianopia and signs of cortical dysfunction.
What is the most severe form of stroke?
Total anterior circulation syndrome
What is partial anterior circulation syndrome?
A stroke with 2 of the following:
- Hemiplegia
- Homonymous hemianopia
- Cortical dysfunction
Where do lacunar infarcts affect?
Deep brain - may be basal ganglia, thalamus or white matter.
Can also affect brainstem.
How does lacunar syndrome present?
Weakness down one-side.
Affects the face, arm or leg.
Which form of stroke has the best prognosis?
Lacunar infarct
What areas of brain are affected by posterior circulation syndrome?
Brainstem
Cerebellum
Occipital lobes
Parietal lobes
How does recovery from stroke take place?
Death of affected tissues with other areas of brain taking over to compensate.
What is the dominant hemisphere of the brain in most people?
Left hemisphere
What roles are carried out by the right cerebral hemisphere?
Creativity
Music
Spatial orientation
Artistic awareness
What roles are carried out by the left cerebral hemisphere?
Spoken language
Reasoning
Number skills
Written language
What is commonly responsible for cardioembolic stroke?
Atrial fibrillation
How does cardioembolic stroke present?
Multiple clots found in multiple arteries.
What is CADASIL?
A genetic condition with increased risk of cerebral amyloid angiopathy.
This leads to strokes.
What effect do metallic/prosthetic heart valves have on clot risk?
Increases it.
Does a patent foramen ovale decrease stroke risk?
No, it increases it.
Around 25% of the population have a patent foramen ovale.
What is carotid artery dissection?
Mechanical tear of the arterial wall, causing a clotting cascade which produces an embolus that can lead to a stroke.
Associated with hypertension.
How is carotid artery dissection treated?
Antiplatelets or anticoagulation.
What are primary causes of haemorrhagic stroke?
Hypertension Amyloid angiopathy Arteriovenous malformation Aneurysm Tumour
Deep,more central cerebral bleeds are commonly caused by what?
Hypertension
Lobular, more peripheral cerebral bleeds are commonly caused by what?
Amyloid angiopathy
How is the location of a bleed determined?
MRI scan
What does microbleeds from small vessels, as shown by MRI indicate?
Amyloid angiopathy
How is intracerebral haemorrhage treated?
Tight blood pressure control.
How is stroke prevented?
Antithrombotic therapy Blood pressure Cholesterol Diabetes Don't smoke
Think ‘ABCDD’.
What should be given following an infarct stroke?
Aspirin for 2 weeks then clopidogrel thereafter.
What should be given following a cardioembolic stroke?
Anticoagulation therapy.
Is the bleeding risk when taking aspirin greater than when taking warfarin?
No, the risk is equal.
What is first-line treatment for hypertension?
If over 55, give CCB.
If under 55, give ACE inhibitor.
What surgery is used to remove atherosclerosis from those at high-risk of stroke?
Carotid endarterectomy
