Stroke & TIA

Question 1

what is a stroke

Answer 1

rapid devlopment of Sx/signs
focal loss of cerebral function
global loss with coma or SAH
lasts >24h
presumed vascular origin

Question 2

stroke pathology

Answer 2

80-85% cerebral infarct

15-20% haemorrhage - primary intracerebral heamorrhage + SAH (5%)

Question 3

TIA

Answer 3

acute loss of focal cerebral function
or
acute monocular visual loss (amaurosis fugax)
last less than 24h, but most are short lived

Question 4

amaurosis fugax

Answer 4

painless temporary visual loss in one or both eyes

Question 5

risk factors for stroke/TIA

Answer 5

age
FH
smoking 
alcohol
recreational drugs
HTN
DM
raised cholesterol
IHD
PVD
AF

Question 6

DDx stroke

Answer 6

SOL
MS
epilepsy with post-ictal deficit
head injury
hypertensive encephalopathy
functional/psychological

Question 7

DDx TIA

Answer 7

migraine
focal epilepsy
hypoglycaemia
MS
peripheral nerve lesions
psychological

Question 8

classification of stroke

Answer 8

anterior (carotid system)

posterior (vertebrobasillar system)

Question 9

middle cerebral artery stroke - parietal, frontal, superior temporal lobes

Answer 9

contralateral:
UMN facial weakness
hemiplegia (arm>leg)
hemianopia
aphasia (dominant)
visuospatial problems (non-dominant)

Question 10

vertebral and basilar artery stroke - brainstem and cerebellum

Answer 10

diplopia, disorders of eye movement
nystagmus, vertigo, vomiting
dysarthria (speech), dysphagia, bulbar weakness (CN IX-XII)
ipsilateral LMN facial weakness
resp failure, coma
contralateral hemiparesis, quadriparesis

Question 11

LACS

Answer 11

motor or sensory deficit only

Question 12

PACS

Answer 12

2 of following motor of sensory deficit:
higher cortical dysfunction
hemianopia

Question 13

TACS

Answer 13

all of:
Homonymous hemianopia
Hemiparesis
Higher dysfunction

Question 14

POCS

Answer 14

isolated hemianopia
brainstem signs
cerebellat ataxia