Strokes for finals folks Flashcards
Stroke Station
Unilateral motor loss of the face, arms or legs
Same half visual loss in both eyes
Partial anterior circulation infarct (PACI)
Two of:
Unilateral motor loss of the face, arms or legs
Same half visual loss in both eyes
Loss of higher functions (eg speech)
One sided facial weakness, homonymous hemianopia and slurred speech
Total anterior circulation stroke
All 3 of:
- One-sided motor +/- sensory loss in face, arms and leg
- Loss of same half of vision in both eyes
- Loss of higher function eg speech
Anterior and middle cerebral arteries
What symptoms indicate a lacunar stroke?
Any of
Pure sensory loss
Unilateral motor +/- sensory loss
Ataxic weakness bilaterally
An isolated homonoymous hemianopia can indicate what kind of stroke? What two other symtpoms does this present with?
Posterior infarct circulation syndrome
- Brainstem syndromes
- Loss of consciousness
- Isolated homonymous hemianopia
Supplied by vertebrobasilar arteries
Stroke by anatomy
Upper > Lower contralateral hemiparesis
+/- sensation loss
Anterior cerebral artery
Stroke by anatomy
Lower > Upper Contralateral weakness
Homonymous hemianopia
Middle Cerebral Artery
Stroke by anatomy
Visual agnosia
Contralateral homonymous hemianopia
Posterior cerebral artery
Stroke by anatomy
Contralateral extremity weakness
Ipsilateral CNIII palsy
Smaller branches of PCA
Known as Weber’s syndrome
Stroke by anatomy
Locked in Syndrome
Basilar arteries
Stroke by anatomy
Pain/temperature loss in limb/torso
IL facial pain + loss
Posterior Inferior Cerebellar Artery
CL Limb/torso pain, temp loss
IL facial pain +/- motor loss
IL deafness on same side as facial pain
Anterior inferior cerebellar artery
PICA + IL facial paralysis and or deafness
How do you investigate a stroke?
1st line: CT to determine if haemorrhagic
GS: Diffusion weighted MRI if unclear
4 hour stroke history without haemorrhage on CT.
Initial treatment?
Definitive treatment?
Alteplase as under 4.5 hours of symptom onset
thrombectomy as within 6 hours (if angiography confirms occlusion of ACA/MRA)
Which ischaemic stroke patients get thrombectomy?
Image confirmation of prox anterior (ACA/MCA) occlusion
Presenting <6 hours of onset
Presenting 6-24 hours onset + imaging evidence of salvageable tissue
When should 300mg aspirin for 14 days be given to stroke patients?
ASAP within 24 hours
BUT AFTER IMAGING + TREATMENT
