Stroke/TIA

Question 1

What is a stroke in evolution?

Answer 1

An enlarging neurological deficit, presumably due to infarction, which increases over 24-48 hours

Question 2

What is a stroke?

Answer 2

A focal neurological deficit lasting longer than 24 hours caused by intracerebral haemorrhage or infarction

Question 3

What are carotid artery symptoms?

Answer 3

Amaurosis fugax (sudden blindness in one eye)
Dysphasia
Unilateral weakness, paralysis or numbness of face and arm +/- leg

Question 4

What are vertebrobasilar artery symptoms?

Answer 4

Homonymous hemianopia
Nausea +/- vomiting
Bilateral blurring or blindness
Dipolopia
Vertigo
Dysarthria
Hemiplegia
Ataxia +/- bilateral weakness or numbness
Drop attacks

Question 5

What percentage of TIAs present as amaurosis fugax?

Answer 5

20%

Question 6

Five years after a TIA what percentage of people (without treatment) will have a stroke?

Answer 6

Average one in three

Question 7

When is the highest risk period after a TIA?

Answer 7

First 6 months

Question 8

What is the ABCD stroke risk tool?

Answer 8

Screening tool useful to predict risk of stroke in 7 days after TIA
A- age >60: 1 point
B- BP > 140 systolic or > 90 diastolic: 1 point
C- clinical features. Any unilateral limb weakness: 2 points. Speech impairment without weakness: 1 point
D- duration. > 60 minutes: 2 points. 10-59 minutes: 1 point
D- diabetes: 1 point
>4 high risk

Question 9

What is the CHADS2 criteria?

Answer 9

Used to calculate appropriate anticoagulation
High risk (2-6 points): warfarin
Moderate risk (1 point): warfarin or aspirin
Low risk (0 points): aspirin 100-300mg daily

Previous stroke or TIA: 2 points
Age >75: 1 point
Hypertension: 1 point
Diabetes mellitus: 1 point
Heart failure: 1 point