Week 3 - Stroke

Question 1

What is a stroke vs TIA?

Answer 1

Transient ischaemic attack is under 24hrs. stroke is longer than

Question 2

What are the 2 main causes of stroke and their prevalence?

Answer 2

infarction - 85-90%

haemorrhage - 10-15%

Question 3

What is large artery disease?

Answer 3

atheromas forming in large arteries, like bifurcation of carotid, due to turbulent flow. this can form clot and embolise and travel to brain causing stroke.

Question 4

What is cardioembolic stroke?

Answer 4

clot formed in left atrium (due to atrial fibrillation) or ventricle and can embolise and enter aorta, then cerebral vessels. cause stroke

Question 5

What is small vessel/lacunar stroke? whats the main cause?

Answer 5

stroke in tiny branches of cerebral arteries going deep into white matter. hypertension is main cause.

Question 6

What is a rare cause of stroke?

Answer 6

carotid dissection - lining of vessel tears and thrombus forms. lodges off and travels to brain

Question 7

What are risk factors for stroke?

Answer 7

hypertension, smoking, APO1: APO2 cholesterol ratios, lifestyle

Question 8

What is the most common cause of stroke?

Answer 8

30% are cryptogenic - no cause found

Question 9

What is significant about haemorrhagic strokes?

Answer 9

higher mortality rate than ischaemic. mostly due to hypertension with small vessel/lacunar stroke.

Question 10

What does treatment aim for? why?

Answer 10

regain blood supply and protect area until it’s regained. 1.9million neurones are lost per minute

Question 11

What does transient mean?

Answer 11

some blood flow - not fully occluded. cells dont die immediately

Question 12

What is the pathophysiology of stroke?

Answer 12

failure of blood flow - hypoxia - apoxia - infarction - necrosis - complete stroke

Question 13

What further damage is caused following a stroke?

Answer 13

oedema. it can push on other brain structures and cause damage/dysfunction

Question 14

How can necrosis occur following ischaemia? (3)

Answer 14

• lactic acid from anaerobic inspiration creates acid-base imbalance and kills cells
• calcium release overexcites cells and activates toxins - killing cells. excitotoxicity.
• reperfusion injury

Question 15

What is the anatomy of the cerebral arteries?

Answer 15

• 2 carotid arteries. both split into external and internal.
• internal carotid split into anterior cerebral and middle cerebral arteries.
• 2 vertebral arteries join to form basilar artery. these divide to form posterior cerebral arteries
• all join by circle of willis

Question 16

What do the anterior and middle cerebral arteries innervate?

Answer 16

frontal, parietal, most of temporal lobe. deep white matter.

Question 17

What do the posterior cerebral arteries innervate?

Answer 17

some temporal, occipital lobes, cerebellum and brainstem

Question 18

What is brocas area used for?

Answer 18

to produce speech

Question 19

What are the temporal, parietal and occipital lobes used for respectively?

Answer 19

temporal - listen
parietal - understanding and sensory
occipital - see and process vision

Question 20

What is the frontal lobe used for?

Answer 20

motor cortex

Question 21

What is the brainstem used for?

Answer 21

heart rate, breath, swallow

Question 22

Which part of the brain is for coordination?

Answer 22

cerebellum