Stroke Flashcards
What is a stroke
sudden onset of focal neurological signs of presumed vascular origin lasting over 24 hrs w sudden onset
What is a TIA?
sudden onset of focal neurological signs of presumed vascular origin lasting less than 24 hr
what are modifiable RFs
age hypertension smoking hyperlipidaemia diabetes mellitus Risk factors for cardioembolism atrial fibrillation
What are non-modifiable RFs
ethnicity
FHx
male
age
What is the classification system for strokes
Oxford Stroke Classification
what criteria are assessed in this system?
- unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
- homonymous hemianopia
- higher cognitive dysfunction e.g. dysphasia
What is total anterior circulation infarcts?
involves middle and anterior cerebral arteries (carotid)
all 3 of the above criteria are present
What is posterior anterior circulation infarct?
involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery
2 of the above criteria are present
What are lacunar infarcts?
involves perforating arteries around the internal capsule, thalamus and basal ganglia
presents with 1 of the following:
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis
What are posterior circulation infarcts Classed as?
involves vertebrobasilar arteries presents with 1 of the following: 1. cerebellar or brainstem syndromes 2. loss of consciousness 3. isolated homonymous hemianopia
What score is used to recognise stroke in emergency settings?
ROsier
What does the rosier score assess?
LOC -1 Seizure activity -1 New, acute onset of: Asymmetrical facial weakness +1 arm +1 leg +1 Speech disturbance +1 Visual defect +1
What score indicates a stroke w the rosier score?
> 0
What parts of the brain does the middle and anterior cerebral artery supply?
frontal and temporal lobe causing contralateral hemiplegia, hemianopia, aphasia
When is immediate CT indicated?
to distinguish between haemorrhagic and ischaemic stroke
indications for thrombolysis or early anticoagulation treatment
on anticoagulant treatment
a known bleeding tendency
a depressed level of consciousness (Glasgow Coma Score below 13)
unexplained progressive or fluctuating symptoms
papilloedema, neck stiffness or fever
severe headache at onset of stroke symptoms.
