Stroke + TIA Flashcards
1
Q
How common is it
A
3rd most common cause of death
2
Q
What are the risk factors
A
- HTN
- DM
- AF
- Hyperlipidaemia
- Structural cardiac disease
- Lifestyle
- ABCD2 score of >4
3
Q
What are the symptoms
A
- Disorder of balance, co-ordination, preception
- Unilateral weakness
- Visual field defect
4
Q
What are the signs / can you tell difference
A
- SUDDEN ONSET - progressing symptoms
- ISCHAEMIC = carotid bruits, AF, past TIA, IHD
- HAEMORRHAGE = meningism, sev headache, coma
5
Q
How does a cerebral infarct present + what % of infarcts is it
A
50% of strokes
- Contralateral hemiplegia
- Initially FLACCID LIMBS –> SPASTIC (UMN) –> contralateral sensory loss + dysphagia + visuo-spatial defect + homonymous hemianopia
6
Q
How does a brainstem infarct present + what % of infarcts is it
A
25%
- locked in syndrome
- quadriplegia
- disturbance to gaze/vision
7
Q
How does a lacunar infarct present + what % of infarcts is it
A
25% Around basal ganglia, internal capsule, thalamus, pons - Cognition intact - Purely motor atxic hemiparesis - Pure sensory - mixed sensorimotor + dysarthria
8
Q
How do you investigated stroke + TIA
A
- CT head
- ABCD2
Age >60yrs = 1 point
BP >140/90mmHg = 1 point
Clinical feat - unilat weakness= 2 point, speech disturbances w.out weakness = 1 points
Duration symptoms >60mins = 2 points
Diabetes = 1 point
9
Q
How do you manage stroke post-operatively
A
DO NOT START ANTI-PLATELET MED until confirmed w/ CT non-haemorrhagic
- Simvastatin
- Antiplatelet e.g. clopidogrel, aspirin
10
Q
How do you manage neuropathic pain
A
Amitriptyline, gabapentin, carbamazepine
