Types of strokes

Question 1

2 types of strokes

Answer 1

Strokes can be classified into two major categories: ¹

Ischaemic stroke (87%)
Haemorrhagic stroke (13%)

Question 2

potential mechanisms which can result in an ischaemic stroke

Answer 2

Embolism: an embolus originating somewhere else in the body (e.g. the heart) causes obstruction of a cerebral vessel, resulting in hypoperfusion to the area of the brain the vessel supplies.

Thrombosis: a blood clot forms locally within a cerebral vessel (e.g. due to atherosclerotic plaque rupture).

Systemic hypoperfusion: blood supply to the entire brain is reduced secondary to systemic hypotension (e.g. cardiac arrest).

Cerebral venous sinus thrombosis: blood clots form in the veins that drain the brain, resulting in venous congestion and tissue hypoxia.

Question 3

medial cerebral supplies what part of the brain

Answer 3

lateral sides

Question 4

Bamford/Oxford classification of ischaemic stroke

Answer 4

TACS
PACS
POCS
LACS

Question 5

difference between TACS and PACS

Answer 5

Total anterior circulation stroke (TACS)

A total anterior circulation stroke (TACS) is a large cortical stroke affecting the areas of the brain supplied by both the middle and anterior cerebral arteries.

All three of the following need to be present for a diagnosis of a TACS:

Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)
Partial anterior circulation stroke (PACS)

A partial anterior circulation stroke (PACS) is a less severe form of TACS, in which only part of the anterior circulation has been compromised.

Two of the following need to be present for a diagnosis of a PACS:

Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)

Question 6

3 features needed to present for TACS

Answer 6

Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)

Question 7

Cranial nerve palsy and a contralateral motor/sensory deficit
Bilateral motor/sensory deficit
Conjugate eye movement disorder (e.g. horizontal gaze palsy)
Cerebellar dysfunction (e.g. vertigo, nystagmus, ataxia)
Isolated homonymous hemianopia

one of these needs to present for what stroke

Answer 7

postererior circualtion syndroms POCS

Question 8

A lacunar stroke (LACS) is a subcortical stroke that occurs secondary to small vessel disease. There is no loss of higher cerebral functions (e.g. dysphasia).

Answer 8

Pure sensory stroke
Pure motor stroke
Sensori-motor stroke
Ataxic hemiparesis