Strokes ☺️ Flashcards

1
Q

Ischemic stroke

  • types
  • pathophysiology
  • prevalence
  • risk factors
A
Most common stroke
TIA - U24hrs
Ischemic stroke - 24hrs+
-thrombosis from large vessel
-embolus often from AF
Both block blood flow
Age
HTN
Smoking
High lipids
DM
AF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hemorrhagic stroke

  • types
  • pathophysiology
  • risk factors
A

Intracerebral hemorrhage
Subarachnoid hemorrhage
Both lead to reduction in blood flow to brain

Age
HTN
AVM
AC use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation

-what additional symptoms are more common in haemorrhagic stroke

A

RAPID FUNCTION LOSS

  • unilateral motor/sensory loss with forehead sparing
  • homonymous hemianopia
  • swallowing problems
  • balance problems

Decreased in LOC
Headache
N+V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Admission and key timeframes

A

ADMIT EVERYONE WITH SUSPECTED STROKE TO STROKE UNIT - within 4hrs of presentation

  • determine symptom onset - when patient was last well if unwitnessed
  • thrombolysis possible within 4.5hrs

KEY INVESTIGATION - Head CT within 1hr of hospital presentation=> is it ischemic or hemorrhagic?
MRI if still not sure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Possible stroke mimic symptoms

A
Gradual onset, progressive, migratory
Positive symptoms
-flashing lights
-tingling, jerking, trembling
-known history of cognitive impairment
-resp, abdo signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of confirmed ischemic stroke

  • definitive
  • CI to thrombolysis
A

Thrombolysis + 300mg aspirin (IV alteplase)
-presentation U4.5hrs AND not CI

CI

  • past intracranial bleed
  • uncontrolled HTN
  • pregnant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of TIA

  • immediate
  • multiple TIA/suspected cardioembolic/carotid cause
  • TIA in past wk
  • TIA in past wk+
A

Immediate 300mg aspirin

Carotid endarterectomy assessment with duplex US - 50-99%

TIA within 1wk => urgent assessment within 24hrs
TIA within 1wk+ => urgent assessment within wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of hemorrhagic stroke

A

NEUROSURGERY REFERRAL

Mainly supportive

  • Reverse AC
  • Lower BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Secondary management of strokes

  • lifestyle
  • medication
A
Increased physical activity
Smoking cessation
Reduce alcohol
Diet optimisation for CVD
T2DM, HF

Clopidogrel
Atorvastatin
HTN management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly