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Revising Group > Vascular > Flashcards

Vascular Flashcards

1
Q

What are the biggest risk factor to having stroke?

A
  • Previous Stroke/ TIA (CVA)
  • Hypertension
  • Diabetes
  • Vascular diseases (e.g. Ischemic heart disease)
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2
Q

What are tools are used to identify stroke?

A

FAST - Face, Arm, Speech, Time
ROSIER - Recognition Of Stroke In the Emergency Room

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3
Q

What is the difference between a TIA and Stroke?

A

In a TIA symptoms should have completely resolved within 24 hours of onset while in stroke symptoms persistent for longer

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4
Q

What are the 2 types of stroke?

A

Ischaemic and haemorrhagic

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5
Q

What are the causes of an ischaemic stroke?

A

Thrombotic stroke
- thrombosis from large vessels e.g. carotid

Embolic stroke
- usually a blood clot but fat, air or clumps of bacteria may act as an embolus
- atrial fibrillation is an important cause of emboli forming in the heart

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6
Q

What are the causes of haemorrhagic stroke?

A

Intracerebral haemorrhage
bleeding within the brain

Subarachnoid haemorrhage
bleeding on the surface of the brain

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7
Q

What are general signs + symptoms of stroke?

A
  • Symptoms present typically asymmetrical
  • Limb weakness
  • Facial weakness
  • Dysphasia (speech disturbance)
  • Visual field defects
  • Sensory loss
  • Ataxia and vertigo (posterior circulation infarction)
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8
Q

What are the symptoms of an anterior cerebral artery?

A

Contralateral hemiparesis and sensory loss, lower extremity > upper

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9
Q

What are the symptoms of a middle cerebral artery?

A

Contralateral hemiparesis and sensory loss, lower extremity < upper
Contralateral homonymous hemianopia
Aphasia

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10
Q

What are the symptoms of a posterior cerebral artery?

A

Contralateral homonymous hemianopia with macular sparing
Visual agnosia

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11
Q

What are the symptoms of a Total anterior circulation infarcts (TACI)?

A

All 3 of:
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

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12
Q

What are the arteries involved in a Total anterior circulation infarcts (TACI)?

A

involves middle and anterior cerebral arteries

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13
Q

What are the symptoms of a partial anterior circulation infarcts?

A

2 of:
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

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14
Q

What arteries are involved in a partial anterior circulation infarcts?

A

involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery

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15
Q

What are the symptoms of a Lacunar infarcts (LACI)?

A

1 of:
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis

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16
Q

What arteries are involved in Lacunar infarcts (LACI)?

A

involves perforating arteries around the internal capsule, thalamus and basal ganglia

17
Q

What are the symptoms of a Posterior circulation infarcts (POCI)?

A

1 of:
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia

18
Q

What arteries are involved in posterior circulation infarcts (POCI)?

A

vertebrobasilar arteries

19
Q

What are the symptoms of a Lateral medullary syndrome?

A

aka Wallenberg’s syndrome
ipsilateral: ataxia, nystagmus, dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
contralateral: limb sensory loss

20
Q

What arteries are involved in lateral medullary syndrome?

A

posterior inferior cerebellar artery

21
Q

What are the symptoms of a Weber’s syndrome?

A
  • ipsilateral III palsy
  • contralateral weakness
22
Q

What arteries are involved in Weber’s syndrome?

A

branches of the posterior cerebral artery that supply the midbrain

23
Q

What are the symptoms of retinal/ophthalmic artery?

A

Amaurosis fugax (a painless temporary loss of vision in one or both eyes)

24
Q

What are the symptoms of basilar artery?

A

Locked in syndrome

25
Q

What is the first like investigation for a suspected stroke?

A

non- contrast CT

26
Q

What is the golden investigation for a suspected stroke?

A

MRI

27
Q

What is the immediate management of a TIA?

A
  • Aspirin 300mg daily (started immediately)
  • Referral for specialist assessment within 24 hours (within 7 days if more than 7 days since the episode)
  • Diffusion-weighted MRI scan is the imaging investigation of choice.
28
Q

What is the immediate management of a stroke?

A
  • Exclude hypoglycaemia
  • Immediate CT brain to exclude haemorrhage
  • Aspirin 300mg daily for two weeks (started after haemorrhage is excluded with a CT)
  • Admission to a specialist stroke centre
29
Q

When is thrombolysis and thrombectomy given for stroke?

A

thrombolysis

Revising Group (20 decks)

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