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Flashcards in Stroke Deck (19)
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1
Q

What is a stroke?

A

Acute onset of focal neurological symptoms and signs due to disruption of blood supply

2
Q

What organs can be affected by a stroke?

A

Brain, spinal chord and eyes

3
Q

What are the two different types of stroke?

A

Ischemic (80%)

Hemorrhagic (20%)

4
Q

What is an ischemic stroke?

A

When a clot blocks blood flow to an area of the brain

5
Q

What is a hemorrhagic stroke?

A

When bleeding occurs inside or around brain tissue due to a torn vessel

6
Q

What are the risk factors to a hemorrhagic stroke?

A

Hypertension
Weakened blood vessels due to structural abnormalities such as an aneurysm or AVM or inflammation of the vessel walls (vasculitis)

7
Q

What is hypoperfusion?

A

Reduced blood flow due to a stenosed artery rather than an occluded artery

8
Q

What are the non-modifable risk factors for a stroke?

A
Age
Family history of vascular disease 
Gender
Race
Previous stroke
9
Q

What are the modifiable risk factors for stroke?

A
Hypertension 
Hyperlipidaemia
Smoking
Prior history of TIA 
AF
Diabetes
CHF
Alcohol excess
Obesity 
Physical inactivity
10
Q

What are some causes of stroke in younger people with minimal risk factors?

A

Homocysteinemia
Vasculitis, antiphospholipid antibody syndrome
Protein S, C, antithrombin 3 deficiency
Paradoxial embolism
Genetic
Cardioembolic (mural thrombi, infective endocarditis, myxoma)
Cervial artery dissection

11
Q

What are the 4 questions to think when investigating a stroke?

A

Is it a stroke?
What kind of stroke it is?
What caused the stroke?
Is the patient receiving appropriate secondary prevention following investigations?

12
Q

What are conditions that a stroke can mimic?

A
Hypoglycaemia
Seizure (postictial states) 
Migraine
Other metabolic - hyperglycaemia, hyponatremia
Space occupying lesions (brain tumour) 
Functional hemiparesis
13
Q

What is the only way to differentiate between an ischaemic and haemorrhagic stroke?

A

Brain imaging - CT brain, MRI

14
Q

What investigations are needed if it is an ischaemic stroke?

A

Find cause of thrombus or embolism

Blood tests - glucose, lipids, thrombophilia, hypertension

15
Q

Where will an atheroembolism travel to?

A

An embolism from a thrombus forming on an atherosclerotic plaque will infarct in the same side as the effected carotid artery

16
Q

Where will a cardioembolism travel to?

A

An embolism from a clot formed in the heart (usually the left atrium) will infarct in more than one arterial territory and could result in a bilateral clot

17
Q

What investigations should be undertaken if a haemorrhagic stroke is suspected?

A

Investigate cause of bleeding (imaging)
Hypertensive - usually deep in brain
If young, not hypertensive and lobar (superifical) haemorrhage then investiage for aneurysm or AVM
If multiple haemorrhages then investigate for vasculitis

18
Q

What medical management is given after an atheroembolic stroke?

A
Antiplatelets (aspirin, dipyridamole or clopidogrel) 
Statins 
Diabetes
Hypertension management 
Lifestyle advice
19
Q

What is a TIA?

A

Temporary neurological symptoms due to occlusion of an artery stopping blood flow - it is temporary because arteries are capable of dissolving small clots