Wk 10.2 Stroke

Question 1

What is the stroke epidemiology worldwide and in the UK?

Answer 1

-1 stroke every 2 seconds (worldwide)
-In the UK – 1 stroke every 5 minutes
- 1 death every 3.3 mins
- More than 100k in the Uk each year.

Question 1

What are some stroke facts ?

Answer 1

-Cause of morbidity
- 2nd leading cause of mortality worldwide
-Vascular dementia is can be caused by stroke
- Large socioeconomic burden
- Secondary disorders such as epilepsy, dementiaand depression

Question 2

What is the estimated cost of stroke in the UK?

Answer 2

£26 million a year

Question 3

What are the controllable risk factors of stroke?

Answer 3

• Smoking
• Drug abuse
• Diabetes
• Heart disease
• Hypertension
• Obesity
• Exercise
• Diet
  (87 % of risk factors can be controlled)

Question 4

What are the other risk factors of Stroke?

Answer 4

• Genetics
• Environment (Southern America)
• Socioeconomic
• Age
• Alcohol abuse
• Drug abuse
  -Mini stroke

Question 5

What is a stroke?

Answer 5

Sudden brain damage and a reduction of blood flow to the brain caused by clots or ruptures to the blood vessel.

Question 6

1.What are the two types of stoke and is the difference?

2. Which one are people most likely to die from ?

Answer 6

1.Ischaemic = Clot
Ischaemic is more common

-Hemorrhagic =Bleeding around brain or into brain

2. Haemorrhagic stroke due to bleedingas there is not enough capacity so it leads to intracranial compression, the brain stem will be pushed down and stop working

Question 7

1.What does Embolic and Thrombotic mean
2. What stroke are they involved in?

Answer 7

1.Embolic= Comes from somewhere else - the heart
Thrombotic = Gathers at a site that has reduced capacity

2. Ischaemic stroke

Question 8

What are the pathological types and subtypes of stroke?

Answer 8

• 5% subarachnoid haemorrhage
  -15 % Intracerebral haemorrhage
• 80% Ischaemic stroke

Question 9

What is cerebral ischaemia?

Answer 9

Glucose and oxygen deprivation (due to reduction in blood flow) to the brain.

Question 10

What are the causes of Ischaemic stroke?

Answer 10

-Atherothromboembolism (MCAo) 50%
-Cardioembolic 20%
- Intracranial small vessel disease (lacunar infarcts) 25%
-Rare or unknown causes 5%

Question 11

What is Transient Ischaemic attack (TIA)?

Answer 11

• Last 15-30mins
  -Results in some neurological dysfunction which disappears within 24 hours
  -Known as mini-stroke
• People who have mini are most likely to have a Ischaemic stroke

Question 12

What are the symptoms of Ischaemic Stroke?

Answer 12

-Numbness of face / legs
- Confusion
- Trouble speaking
-Trouble seeing
- Trouble walking and dizziness
- Severe headaches with no known cause

Question 13

What are the deficits caused by stroke?

Answer 13

-Seizures
-Memory and concentration difficulties
-Hemiparesis- weakness in one side of the body

Question 14

Why is Ct scan used more than MRI scan?

Answer 14

Because it is less expensive and takes less time

Question 15

What does absence of blood flow cause?

Answer 15

Neurons will die within minutes

Question 16

What is the cerebral BF amount

Answer 16

50-60ml/100g/min

Question 17

What is the Macroscopic pathophysiology?

Answer 17

-In normal - a small fraction of o2 is extracted from the blood and metabolised by the brain tissue

• When regiona blood flow decreases as a result of vessel occlusion and OEF is no longer sufficient for metabolism = metabolic deficiency

Question 18

What neurotransmitter is involved in ischaemic cascade?

Answer 18

Glutamate

Question 19

What is Ischaemic cascade?

Answer 19

lack of o2 and glucose to brain tissue