Lecture 10.1: Stroke Flashcards
What is a Stroke?
Brain injury caused by the sudden disruption of blood flow to the brain which can be due to Infarction or Haemorrhage
What is an Infarction?
Tissue death or necrosis due to inadequate blood supply to the affected area
What is a Haemorrhage?
Acute loss of blood from a damaged blood vessel
What percentage of Strokes are due to infarctions? What are the 2 types of infarctions?
- 85%
- 50% thrombotic
- 35% embolic
What percentage of Strokes are haemorrhagic?
10%
What percentage of Strokes are due to Subarachnoid Haemorrhage?
5%
What is a Thrombus?
A blood clot formed in situ within the vasculature impeding blood flow
What is an Embolus?
Blood clots, fatty deposit or air bubble carried in the blood stream that lodges in a vessel
What is a Primary Haemorrhage?
Escape of blood from a ruptured vessel with no structural anomaly
What is a Secondary Haemorrhage?
Escape of blood from a ruptured vessel with aneurysm, vascular malformation or tumour
What is a Teritary Haemorrhage?
Escape of blood from a ruptured vessel with haemorrhagic transformation of an infarction
What is a Transient Ischaemic Attack (TIA)?
Focal CNS disturbances caused by vascular events that last <24hrs and with no lasting deficit, “mini stroke” is caused by a temporary disruption in the blood supply to part of the brain
Clinical Symptoms of Stroke in Anterior Circulation (5)
- Left hemisphere - Language trouble
- Right hemisphere – Neglect
- Weakness
- Partial visual loss
- Numbness
Clinical Symptoms of Stroke in Posterior Circulation (4)
- Blindness
- Diplopia
- Bilateral weakness
- Vertigo
Modifiable Risk Factors of Strokes (8)
- Hypertension
- Cardiac Diseases (AF)
- Diabetes
- High Cholesterol
- TIA
- Physical Inactivity
- Smoking
- High Intake of Alcohol
Investigations for Stroke (9)
- ECG: Atrial Fibrillattion or flutter
- Echo: Check for clots
- Ultrasound of the carotid artery < 70% stenosis
management with medication - 70% symptomatic - Carotid endarterectomy / Stent
- HBA1C
- Lipid profile
- CBC
- Coagulation profile
Carotid Artery Stenosis Treatment
- Surgery with angioplasty and a stent
- Lifestyle Changes
- Medication
What is Ischaemic Penumbra?
Defined as the severely hypoperfused, functionally impaired, at-risk but not yet infarcted tissue that will be progressively recruited into the infarct core