Stroke/TIA Flashcards
What is the difference between Stroke and TIA?
TIA is a transient episode of neurological dysfunction caused by ischaemia without infarction
Stroke is an acute/focal neurological deficit resulting from a vascular disease
Presentation of strokes/TIAs affecting anterior circulation
- Unilateral weakness / sensory loss
- Facial droop
- Speech disturbance
- Visual disturbance e.g. hemianopia/visual inattention
- Neglect/inattention
Presentation of strokes/TIAs affecting posterior circulation
- Ataxia
- Vertigo
- Dysarthria (difficulty speaking due to muscle weakness)
- Nyastagmus
- Diplopia
- Nausea and vomiting
What is Lacunar Anterior Circulation Stroke (LACS)
A subcortical stroke - occurs due to occlusion of perforator artery/small vessel disease
“Pure” sensory/motor or sensory-motor
Signs of Partial Anterior Circulation Stroke (PACS) & Total Anterior Circulation Stroke (TACS)
- Unilateral sensory+/- motor disturbance of the face, arm and leg
- Homonymous hemianopia
- Higher cerebral dysfunction (dysphasia/visuospatial disorder)
Signs of Posterior Circulation Stroke (POCS)
ONE of:
Cerebellar or brainstem syndrome
Loss of consciousness
Isolated homonymous hemianopia
When investigating stroke, why is a CT head done?
Identify haemorrhage
When investigating stroke, why is a carotid USS done?
- Looking for anterior circulation strokes
- Looking for internal carotid artery stenosis
When investigating stroke, why is a Transthoracic echocardiogram done?
Looking for:
Mural thrombus,
LV function,
Valvular pathology,
What bloods are done in patients presenting with stroke?
FBC
U&Es
LFTs
Clotting
Hb1AC
Lipid profile
Hyperacute management of ischaemic stroke
- Thrombectomy (if presenting within 6 hr)
- Thrombolysis if presenting within 4.5 hr
Acute management of ischaemic stroke
- Aspirin 300mg (ischaemic stroke)
BP management:
Target <185/110mmHg - IV Labetalol 1st line
- Establish on PO antihypertensives ASAP
