Symptoms and Treatment of Stroke

Question 1

Do stroke symptoms come on quickly or slowly?

Answer 1

Quickly

Question 2

Which arteries supply the brain?

Answer 2

External carotid
Internal carotid
Vertebral arteries

Question 3

What does the vertebro-basilar system supply?

Answer 3

The brain stem, cerebellum and occipital lobes

Question 4

Where does the carotid system supply?

Answer 4

Most of the hemispheres and cortical deep white matter

Question 5

What are the common signs of a stroke?

Answer 5

Motor (clumsy or weak limb)
Sensory (loss of feeling)
Speech: slurred or loss
Neglect / visuospatial problems
Vision: loss in one eye, or hemianopia
Gaze palsy

Question 6

What is the most important symptom of someone with a stroke?

Answer 6

Reduced function

Question 7

Define Dysphasia

Answer 7

Difficulty putting sentences together e.g. putting words in the wrong order

Question 8

Define Dysarthria

Answer 8

Difficulty speaking e.g. slurring

Question 9

What may be symptoms of a stroke affecting the brainstem?

Answer 9

Ataxia-cannot control movement
Vertigo- dizziness
Incoordination
Nystagmus

Question 10

What are some of the symptoms of Anterior Cerebral Artery occlusion?

Answer 10

Paralysis of contra-lateral foot and leg

Sensory loss over contra-lateral toes, foot and leg

Impairment of gait and stance.

Question 11

What are some of the symptoms of Middle Cerebral Artery occlusion?

Answer 11

Contra-lateral paralysis of face/arm/leg

Contra-lateral sensory impairment

Contralateral homonymous hemianopia- lose half of vision

Gaze paralysis to the opposite side

Aphasia if stroke on the dominant (left) side so unable to speak

Unilateral neglect for half of external space if non-dominant stroke (usually right side).

Question 12

In which type of stroke is there none of the usual stroke symptoms?

Answer 12

Small vessel artery occlusion

Question 13

What is the type of stroke which affects only a small part of the brain?

Answer 13

Small vessel (lacunar) stroke

Question 14

Which parts of the brain might be affected by a posterior artery stroke?

Answer 14

Brain Stem / Cerebellum / Thalamus
Parts of occipital and temporal lobes

Question 15

What are some of the symptoms for a posterior artery stroke on the brain?

Answer 15

Coma, drop attacks, vertigo, nausea,
Vomiting, cranial nerve palsies, ataxia.
Hemiparesis, hemisensory loss
Crossed sensori-motor deficits
Visual field deficits

Question 16

What are the four subgroups of stroke?

Answer 16

TACS: Total anterior circulation stroke
PACS: Partial anterior circulation stroke
LACS: Lacunar stroke
POCS: Posterior circulation stroke

Question 17

Approx how many patients will die in the first year after a stroke?

Answer 17

1/3

Question 18

What % of stroke survivors become dependant on others?

Answer 18

50%

Question 19

Which types of cholesterol are important when it comes to strokes?

Answer 19

Lipoprotein, apoA and apoB

Question 20

What are some of the conditions which are associated with strokes?

Answer 20

Previous TIA or strokes
Blood pressure poorly controlled
Angina
MI
Peripheral vascular disease
Aortic aneurysm
Carotid bruits
Renovascular disease
(Cocaine/ alcohol abuse)

Question 21

What is the most important modifiable risk factor when it comes to stroke?

Answer 21

Hypertension

Question 22

How much of an increase is their in developing a stroke because of diabetes?

Answer 22

3x

Question 23

How much of an increase is their in developing a stroke because of smoking?

Answer 23

2x

Question 24

Discuss why alcohol is a complicated risk factor of developing a stroke?

Answer 24

Small amounts of alcohol decreases stroke risks.
Large amounts of alcohol increase the risk by 2.5 x

Question 25

What are some of the purposes of stroke treatment?

Answer 25

Protect the damaged brain before ischaemia becomes cell death

Get rid of the clot

Prevent the clot happening in the first place

Question 26

What things should acute stroke therapies do?

Answer 26

Restore blood supply.
Prevent extension of ischaemic damage.
Protect vulnerable brain tissue.
Avoid reperfusion injury
Be non-toxic

Question 27

Which drug can be given as thrombolysis?

Answer 27

Alteplase

Question 28

How long after a stroke can you give a patient alteplase?

Answer 28

Within four and a half hours after a stoke

Question 29

What does alteplase do?

Answer 29

Digests the clot and restores blood flow.

Question 30

What does the FAST campaign stand for regarding strokes?

Answer 30

F-face
A- arms, can they be raised above the head?
S- speech/slur
T- time to call 999

Question 31

What will CT tell us about stroke?

Answer 31

It can exclude haemorrhage

Question 32

What are the pros and cons of an MRI?

Answer 32

Lot better quality but takes 1/2 an hour

Question 33

Name some types of treatment which can help with stroke.

Answer 33

Antiplatelets
Statins
Blood pressure management

Question 34

What medication should those with atrial fibrillation be on?

Answer 34

Anticoagulation (apixaban, rivaroxaban)

Question 35

OKAY REVISION TASK BESTIE

Answer 35

Go onto term 2, 27 February - 3 March (Cardiovascular)
Under the stroke lectures in Atherosclerosis 3 is a website w lots of stuff to do w strokes! Create a mind map or something and go through and answer the learning outcomes on the website before reading and fill in any gaps <3