4: Stroke 2 - the sequel Flashcards Preview

Neurology Week 3 2018/19 > 4: Stroke 2 - the sequel > Flashcards

Flashcards in 4: Stroke 2 - the sequel Deck (43)
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1

What is a stroke?

Loss of brain function secondary to cardiovascular disease 

2

There are a lot of diseases which ___ stroke.

mimic

3

Which neurological symptom is most often mistaken for stroke?

Seizure

4

Which widespread infection affecting the major organs can mimic stroke?

Sepsis

5

What is more common - cerebrovascular disease or coronary artery disease?

Cerebrovascular disease

6

Which score is used to assess the likelihood that a patient has suffered a stroke?

ROSIER Score

7

What are the two general types of stroke?

Haemorrhagic

Infarction

8

What colour is 

a) blood

b) infarcted tissue

on CT?

Blood is white, well enhancing

Infarcted tissue is black/grey

9

After which length of time is CT NOT sensitive for blood?

Which scan should you use instead after this period?

1 week

MRI

10

Which area of the brain circulation, when infarcted, carries the worst prognosis in stroke?

Anterior circulation

11

What happens to infarcted brain tissue in the weeks following a stroke?

Scarring

12

Which type of stroke has the best prognosis?

Which brain structures are affected?

Lacunar infarction

Basal ganglia, thalamus, brainstem

13

Which area of brain circulation, when infarcted, lead to cranial nerve palsies and blindness ?

Posterior circulation

14

In most people, which side of the brain is dominant?

Left side (most people are right-handed, remember everything is mirrored)

15

Which side of the brain is responsible for musical ability and 'artistic awareness'?

Right side

16

Which disease processes are responsible for most ischaemic strokes?

Atherosclerosis > Thrombosis > Embolism

17

Which investigation can be used to view blood vessels for thrombosis?

CT / MR angiogram

18

Atherosclerosis affecting the ___ arteries and ___ vessels is the most common reason for ischaemic stroke.

coronary arteries and small vessels

19

Small vessel disease tends to affect the ___ matter of the brain.

white matter

20

Which arrhythmia commonly causes embolism of thrombi to the brain?

AF

21

Why can MI cause embolism of clots to the brain?

Heart isn't pumping - stasis - Virchow's triad

Scar tissue also pings off

22

People with ___ valves are more likely to have embolic events.

prosthetic valves

23

Which congenital heart disease can cause a stroke?

Patent foramen ovale 

Clots which would usually cause a PE can cross to the left side of the heart and travel to the brain

24

What is an arterial dissection?

Rip in the tunica intima of an artery, allowing blood to get in

25

What are two ways in which arterial dissection causes ischaemic stroke?

1. Bulging of blood in wall occludes lumen of vessel

2. Static blood coagulates and can ping off as thrombi

26

What are two primary causes of haemorrhagic stroke?

Hypertension

Amyloid angiopathy

27

What are some causes of secondary haemorrhagic stroke?

Tumour, aneurysm, trauma etc.

anything which causes bleeding in the cranial cavity

28

___ ___ must be reduced in people with primary haemorrhagic stroke.

Blood pressure 

29

Bleeding into the cranial cavity causes an increase in what?

ICP

30

Similarly to MIs, time means ___ brain tissue.

lost