Flashcards in Stroke Deck (54)
What is the definition of stroke?
A sudden onset of focal or global neurological symptoms caused by ischameia or haemorrhage which lasts >24hrs.
What is the most common type of stroke?
How long do symptoms of TIAs usually resolve in?
What is the time period that TIAs are defined by?
Symptoms lasting < 24hrs
What are the main causes of ischaemic stroke?
Large artery atherosclerosis
Small artery occlusion
What are the main causes of haemorrhagic stroke?
Primary intracerebral haemorrhage
Secondary (SAH, AV malformation)
What imaging would you use in stroke?
What is the pathophysiology behind an ischaemic stroke?
Failure of cerebral blood flow due to interruption. This causes hypoxia and
When there is no oxygen (anoxia), infarction occurs & cell death.
What are some of the modifiable risk factors for stroke?
What are some of the non-modifiable risk factors for stroke?
Previous history of stroke
What is the most important modifiable risk factor for stroke?
What is the name of the small end arteries?
What area of the brain will be affected in a receptive dysphagia?
What area of the brain will be affected in a expressive dysphagia?
If the ACA is blocked, where will symptoms be observed?
IF the MCA is blocked, where will symptoms be observed?
Arms, hands, face
What arteries comprise the anterior circulation of the brain? What is their origin
What arteries comprise the posterior circulation of the brain? What is their origin
(2 verebral arteries which form basilar)
3 cerebellar arteries
What arteries are responsible for the anatostomoses that comprise the Circle of Willis?
Anterior & posterior communicating arteries
Where does the anterior circulation of the brain arise?
What are the symptoms of ACA occlusion?
Contralateral foot & leg paralysis
Impairment of gait
What are some of the symptoms of MCA occlusion?
Leg/Arm/Face paralysis & loss of sensation
Aphasia (if affected dominant hemisphere)
Unilateral neglect & agnosia
If a stroke affects the Left side of the brain, what will be observed?
Right sides hemiplegia
What artery supplies the internal capsule?
What symptoms will be observed in a stroke on the right side of brain?
Visual & sensory agnosia
What is hemiparesis?
Loss of motor function on one side of body
What are some of the symptoms of a lacunar artery stroke?
What are some of the symptoms of a PCA stroke?
Hemiparesis & sensory loss
Visual field defects
What are the different stroke classifications?
What is the most effective stroke treatment in first 3 hrs?
Thrombolytic therapy (TPA)
What type of treatment can be used in large vessel occlusions?
Thrombectomy (clot retrieval)
Who are the different people present on a stoke unit?
Speech & language therapist
What are the strict criteria for TPA use?
< 4.5 hrs onset of symptoms
Have to show disabling neulogical deficits
Symptoms > 1hr
What may prevent the use of TPA?
Any signs of haemorrhagic/ bleeding tendency
For what stroke types can TPA be used?
What investigations may you do in stroke patient?
Bloods (FBC, Glucose, lipids)
CT or MRI head scan
Anterior circular - carotid doppler US scan
What treatment may be given to someone following TIA to prevent stroke?
What are the differentials for a stroke?
Demented patient with UTI
What preventative drugs would be given after?
(Anti-coagulate in AF)
What does ischaemia mean?
Lack of blood flow
What does hypoxia mean?
Lack of oxygen
The interruption of blood flow to the brain can be defined by Virchows triad whats this?
Change in blood flow
Change in blood constituents
What are the 3 main causes of localised interrupted blood flow?
Atheroma + thrombosis
If thrombus is present in ICA, which cerebral artery will be affected?
Where will a thromboembolism usually originate?
Left atrium in those with AF
What arteries will it move through until it reaches the brain?
Left atrium > Common carotid artery > ICA > MCA
If rupture of cerebral artery occurs, what will be observed?
Where are the 2 most common sites of haemorrhagic stroke?
Basal ganglia (microaneurysms)
Circle of Willis (berry aneurysms)
What are 3 examples of brain injury caused by generalised interrupted blood flow?
When will Watershed infarcts present?
When there is poor perfusion with oxygenated blood
What are Watershed infarcts?
Areas of ischaemias that are present at the zonal territory of arterial supply
What will hypotension at the brain result in?
What will cardiac arrest result in?