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BB 2 > Strokes > Flashcards

Strokes Flashcards

1
Q

Define stroke

A

Condition characterised by rapidly progressive clinical symptoms and signs of focal loss of cerebral function lasting >24 hours

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2
Q

What % of strokes are ischaemic

A

70-80%

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3
Q

What % of strokes are haemorrhagic

A

20-30%

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4
Q

Prevelance of strokes

A

5/1000

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5
Q

What % of people who have a stroke die within the year

A

1/3

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6
Q

What is the leading cause of severe disability

A

Stroke

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7
Q

3 causes of haemorrhagic strokes

A

Subarachnoid
Intracerebral
Subdural

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8
Q

What are the steps of the mechanism of an intracerebral haemorrhage

A

Charcot-Bouchard microaneurysms
Microbleeds
Haemorrhagic transformation of infarcts
Vasculitis

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9
Q

Primary cause of intracerebral haemorrhage

A

Hypertension

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10
Q

What are the complications that could occur from an intracerebral haemorrhage (40

A

Local damage
Local mass effect
Raised ICP
Hydrocephalus

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11
Q

5 steps of managing a ICH

A 
Establish cause
Stop aspirin/ warfarin
Treat complications
Treat risk factors
Rehabilitation
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12
Q

Symptoms of a subarachnoid haemorrhage

A

Sudden severe headache
Nausea and vomiting
Aneurysms

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13
Q

What usually causes subarachnoid haemorrhage (3)

A

Trauma
Ruptured intracranial aneurysm
Arteriovenous malformation

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14
Q

Symptoms of subdural hematoma

A

Numbness, disorientation, slow onset, irritability, headache

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15
Q

Name some causes of ischaemic strokes

A 
Atherosclerosis
Carotid stenosis
Carotid dissection
Cardiac
Fat embolism
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16
Q

What does ischaemia immediately cause

A

Failure of Na+/ K+ pumps

Depolarisation

17
Q

What does the depolarisation that results from ischaemia lead to

A

Glutamate release

Opening of calcium channels

18
Q

What does glutamate release stemming from ischaemia lead to

A

AMPA receptors
Metabotropic receptors
NMDA receptors

19
Q

Combined effect of glutamate and calcium channel opening?

A

Elevated intracellular calcium and cell death

20
Q

Name some non-modifiable risk factors for strokes

A 
Age
Previous stroke
Gender
Ethnicity
Family history
21
Q

Name some modifiable risk factors for strokes

A 
Hypertension
Hyperlipidemia
Smoking
CV disease
Diabetes
22
Q

What signs are there if a stroke has affected the anterior circulation

A

Unilateral motor deficit
Homonymous hemianopia
Higher cerebral function

23
Q

What signs are there if a stroke has affected the posterior circulation

A

Pure hemianopia
Cerebellar signs
Diplopia
Bilateral/ crossed sensory-motor signs

24
Q

What kind of strokes does TOAST classification focus on

A

Acute ischaemic strokes

25
Q

5 types of strokes in TOAST classification

A 
Large-artery atherosclerosis
Cardioembolism
Small-vessel occlusion
Stroke of other determined aetiology
Stroke of undetermined aetiology
26
Q

How can large artery atherosclerosis further be categorised

A

Embolus or thrombosis

27
Q

4 categories of a LACI (lacunar) stroke

A

Pure motor
Pure sensory
Ataxic hemiparesis
Sensorimotor

28
Q

What % of people are suitable for thombolysis

A

20

29
Q

What brain structures are supplied by the middle cerebral artery

A

Motor cortex
Sensory cortex
Brocas and Wernickes
Primary auditory cortex

30
Q

Is the somatosensory cortex in the right or left cerebral hemisphere

A

Right

31
Q

Is the motor cortex in the right or left cerebral hemisphere

A

Right

BB 2 (28 decks)

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