strokes and transient ischaemic attacks

Question 1

what are strokes?

Answer 1

rapidly developing symptoms of local or global disturbances of cerebral functions which lasts more than 24 hours or leads to death

Question 2

what are transient ischsemic attacks?

Answer 2

transient neurological dysfunctions caused by ischaemia which last less than 24 hours

Question 3

state and explain the 3 types of transient ischaemic attacks?

Answer 3

large artery flow TIA: short lived and often recurrent
embolic TIA: lasts hours not minutes and is not recurrent
small penetrating vessel TIA

Question 4

give 4 clinical features of a TIA?

Answer 4

sensory loss
reduced speech ability
loss of balance
loss of vision

Question 5

give 4 clinical features of a stroke which are different to those of a TIA?

Answer 5

coma
severe headache
weak face/arms/legs
loss of coordination

Question 6

what is the difference between an ischaemic and haemorrhage stroke?

Answer 6

haemorrhage: bleed in the brain
ischaemic: narrowing / weakening of the blood vessels, can be thrombotic = as a complication of artherelesclerosis or embolic = an embolus of fatty material from a plaque blocks vessels

Question 7

give 6 risk factors of a stroke?

Answer 7

previous stroke
heart failure
atrial fibrillation
diabetes
smoking
high cholesterol

Question 8

give 3 early complications of a stroke?

Answer 8

delirium
venous thromboembolism
cerebral oedema

Question 9

give 3 long term complications of a stroke?

Answer 9

mobility problems
swallowing issues
fatigue

Question 10

what are the 10 first steps in acute stroke management in the first few hours?

Answer 10

1) ensure airways are open
2) monitor blood glucose
3) monitor blood pressure
4) CT or MRI scan
5) thrombolysis
6) no administration by mouth
7) keep hydrated
8) explain what has happened
9) antiplatelet agents
10) admission to a stroke unit

Question 11

what is secondary management of a stroke?

Answer 11

looking after the patients life for example considering carers, if they can drive etc

Question 12

what 4 secondary prevention medications can be used after a stroke?

Answer 12

antiplatelet therapy: clopidogrel and aspirin
lipid treatment: atorvastatin
hypertension treatment
(anticoagulants: only to be used post stroke if patient also has atrial fibrillation or flutter)