stroke/tia Flashcards
stroke
rapid-onset cerebral deficit with focal neurological signs due to vascular ischaemia
stroke types
ischaemic (common)
haemorrhagic
ischaemic stroke aetiology
vascular occlusion: embolus, thrombosis
vascular stenosis
haemorrhagic stroke aetiology
vascular rupture: bleeding, trauma
iatrogenic: anticoagulants,
thrombolysis
stroke risk factors
high: hypertension, hypercholesterolaemia
drugs: smoking, alcohol excess
lifestyle: sedentary
conditions: atrial fibrillation, diabetes, malignancy, anti-phospholipid syndrome, thrombophilia
stroke presentation
hemiparesis
dysphasia
ataxia
visual disturbances
hemisphere infarct features
contralateral hemiplegia
dysphasia
homonomous hemianopia
brainstem infarct features
quadriplegia
disturbed vision
“locked-in syndrome”
lacunar infarct features
motor and/or sensory deficit
Cognition usually intact
stroke investigations
non contrast CT head
bloods: glucose, U&Es, FBC, cardiac enzymes, FBC
ECG
CT/MRI angiography
carotid ultrasound
acute stroke treatment
ABCDE
antiplatelet (once haemorrhagic stroke excluded!)
- aspirin 300mg
- dipyridamole 200mg
thrombolysis (if not contraindicated)
lifelong warfarin prophylaxis (if embolic stroke)
transient ischaemic attack (TIA)
temporary occlusion of cerebral circulation, causing focal neurological deficit without impaired consciousness
List causes of TIA
Atherothromboembolism Mural thrombus (AF, post-MI) Valve disease Hyperviscous blood (polycythaemia, sickle cell) Vasculitis
List clinical features of TIA
Single or multiple attacks
Amaurosis fugax - curtain down over vision
Carotid bruit
Signs mimic vascular territory
Outline treatment of TIA
Control CVS risk
Aspirin 300mg/clopidogrel 75mg
Carotid endarterectomy
Avoid driving for 1 month
