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Cardiovascular system SA > Stroke – presentation and investigation **(eye thing to be re-explained) > Flashcards

Stroke – presentation and investigation **(eye thing to be re-explained) Flashcards

1
Q

What is the definition of a stroke

A 
Neurological deficit (‘loss of function’)of sudden onset, 
lasting more than 24 hours, of vascular origin
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2
Q

How long does a Transient Ischaemic Attack - precursor of a stroke

A

less that 24 hours

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3
Q

What is the symptoms of a stroke

A

Loss of power - motor weakness

Loss of sensation/feeling

Loss of speech

Loss of vision

Loss of coordination

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4
Q

What is the two different forms of loss of speech

A

Dysarthria - struggle to from the words

Dysphasia - struggle to find the words

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5
Q

What is the different loss of visions that can occur in a stroke

A

loss in one eye,
hemianopia - blindness over half the field of vision
Gaze palsy - symmetric limitation of the movements of both eyes in the same direction

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6
Q

What is the different forms of loss of coordination in a stroke

A

Ataxia - loss of all body movements
vertigo - sensation of loss of balance
incoordination - lack of coordination
nystagmus - rapid involuntary movements of the eye

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7
Q

What is the pathology of a stroke

A

damage to part of the brain due to a blockage of a blood vessel through thrombus or embolus or due to haemorrhage from a rupture blood vessel

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8
Q

What is the aetiologies of a stroke

A

85% infarction

15% haemorrhage

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9
Q

What is the anterior and posterior circulation joined by in the brain

A

circle of willis

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10
Q

What is the pathway of the anterior circulation in the brain

A

The internal carotid artery divides into the middle cerebral artery and the anterior cerebral artery which goes into the communicating artery

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11
Q

What is the pathway of the posterior circulation in the brain

A

The vertebral arteries join at the base of the brain to from the basilar artery then branch to from the superior cerebellar artery and posterior cerebral artery

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12
Q

What does the carotid system supply

A

most of the hemispheres - anterior and middle cerebral and cortical deep white matter

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13
Q

What does the vetero-bassilar system supply

A

supplies the posterior cerebral, the brain stem, cerebellum and occipital lobes

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14
Q

What is the problem of a small stroke occurring in an area of fibres being packed closely together

A

Causes major deficit

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15
Q

What does the symptoms of a stroke depend

A

Which part of the brain is affected

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16
Q

What is the different aetiologies of an ischaemic stroke

A

Large artery athlersclerosis
cardioembolic stroke
Lucunar stroke
Rarer causes

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17
Q

What artery goes through athersclerosis resulting in a stroke

A

stenosis of the carotid

18
Q

What causes cardioembolic stroke

A

atrial fibrillation -irregular heartbeat that can lead to blood clots

19
Q

What causes lacunar stroke - small artery occlusion

A

Normally due to hypertension, thickening wall meaning narrowing arteries

20
Q

What can the occlusion of many small arteries result in

A

Major defecit

21
Q

What is examples of rare cases of ischaemic strokes

A

Carotid arterial dissection (spontaneous or traumatic)

Venous sinus thrombosis

22
Q

Where does primary haemorrhage occur

A

intraceterbral

23
Q

where does secondary haemorrhage occur

A

subarchnoid or ateriovenous malformation

24
Q

What is the possible aetiologies of a ruptured blood vessel

A

Hypertension aneurism

25
Q

What needs to be differentiated to localise the area of the stroke

A

Left or right
Carrotid or verterobasilar territory
Cerebral hemispheres or brainstem
cortex or deep white matter

26
Q

The signs and symptoms on examination provide you with what information

A

What side of the brain is affected
whether lesion is in the brainstem, cortex, white matter
and what blood vessel is involved

27
Q

If leison is found in the white matter what kind of stroke is it

A

Lacunar stroke

28
Q

What is the use in localising stroke

A

Confirm the diagnosis
Allow better selection of imaging
give indications of cause
give an indication of the prognosis

29
Q

What is the 4 subtypes of strokes

A

Total anterior circulation
Partial anterior circulation stroke
Lacunar stroke
Posterior circulation stroke

30
Q

What is the symptoms of TACS

A 
weakness, 
sensory deficit
Homonymous hemianopia (loss of vision)
Higher cerebral dysfunction (eg dysphasia, dyspraxia)
31
Q

What is TACS due to

A

occlusion of proximal Middle cerebral artery + internal carotid artery

32
Q

What is the symptoms of PACS

A 
2 of 3 
weakness, sensory deficit
Homonymous hemianopia (loss of vision)
Higher cerebral dysfunction (eg dysphasia, dyspraxia

e.g. just one limb, face, and cerebral dysfunction

33
Q

What is PACS due to - what does this mean

A

occlusion of branches of middle cerebral artery - smaller stroke

34
Q

Where does a lacunar stroke occur

A

Internal capsule - where motor and sensory fibres are coming down

35
Q

What is the symptoms of Lacunar stroke

A

Weakness of one side, involving 2 of the 3 body areas (face, arm, leg), and loss of sensory everywhere

36
Q

How can a lunar stroke go silent and un-diagnosed

A

As there is no problems with their speech, awareness or their co-ordination

37
Q

A bigger lacunar stroke will dow what

A

affect sensory and motor

38
Q

What does POCs affect

A

Brain stem
cerebellum
occipital lobes

39
Q

What is the presentations of a POCS stroke

A 
motor/sensory deficit 
- Disordered eye movement/Hemianopia 
-Coma 
-Disordered breathing 
-Tinnitus - ringing in the ear 
-Vertigo - loss of balance 
Horner’s - sympathetic trunk damage
40
Q

What is the investigations for a stroke

A

Full blood test

ECG

CT scan

MRI - differentiates between haemorrhage and ischaemic

ECHO

Cardiovascular system SA (43 decks)

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