Cerebrovascular Disease

Question 1

What is a stroke ?

Answer 1

Acute focal neurological deficit lasting longer than 24 hours or causing sudden death with no apparent cause other than a vascular one
Incomplete recovery: ischaemia and infarction

Question 2

Give an example of when a stroke occurs

Answer 2

Hemiparesis flowing a middle cerebral artery thromboembolus

Question 3

Describe the symptoms of a stroke

Answer 3

FAST:

Facial drooping, arm/leg weakness, slurred speech and Time greater than 24 hours

Question 4

State 2 other features of a stroke

Answer 4

1. Blurred or loss of vision

2. Hemiparesis

Question 5

What is a TIA ?

Answer 5

Acute focal neurological deficit lasting less than 24 hours usually mins-hours. There is complete recovery: ischaemia without infarction

Question 6

What is amaurosis fugax?

Answer 6

Sudden loss of transient vision I’m in one eye

Question 7

What does an amaurosis fugax often occur with and what can the be the evidence of ?

Answer 7

Amaurosis often occurs with a TIA and can be evidence of an internal carotid artery stenosis

Question 8

What do patient describe amaurosis fugax as ?

Answer 8

Curtain coming down

Question 9

What is a AF and describe how it can give rise to a stroke ?

Answer 9

AF is an irregular rhythm abnormality, which causes stasis of blood in the atria. This leads to the formation of a thromboembolus in the heart, which can dislodge and travel to the brain to cause a stroke

Question 10

State the 4 non-modifiable risk factors for development of a ischaemic stroke 😭

Answer 10

1. Increasing age
2. Being male
3. FH/PH
4. Coagulation disorders: SHAT: SLE, hyper-viscosity, amyloidosis and thrombophilia/penia

Question 11

State the 7 modifiable risk factors for development of a ischaemic stroke

Answer 11

Hypertension, DM, hypercholesterolaemia, obesity, smoking, alcohol and drugs, e.g OCP

Question 12

State the 5 Embolic risk factors for development of a stroke

Answer 12

1. AF, 2. MI, 3. IE, 4. Carotid artery stenosis and 5. Sleep apnoea

Question 13

State the 3 features of menigism

Answer 13

Headache, neck stiffness and photophobia

Question 14

State 2 signs of menigism

Answer 14

positive kernig’s and brudinski’s sign

Question 15

Describe a positive kernig’s sign

Answer 15

Pain on extension of the leg of a previously flexed knee or inability to extend the knee, when hip is flexed

Question 16

Describe the brudinski’s sign

😭

Answer 16

Involuntary lifting of the legs when Patient lifts up their head

Question 17

State 4 signs of a SAH 😭

Answer 17

1. Menigism, 2.Positive kernig’s sign, 3.tersons syndrome and 4. Focal neurological deficits may occur depending on site of aneurysm

Question 18

What is terson’s syndrome ?

Answer 18

Retinal and subhyaloid vitreous bleeds

Question 19

An aneurysm int the posterior circulation may lead to what ? 😭

Answer 19

NADs

Nystagmus, ataxia and dizziness

Question 20

An aneurysm in the posterior communicating artery may lead to what ?

Answer 20

3rd cranial nerve palsy: DEP

Diplopia, enlarged pupils and ptosis

Question 21

State 4 complications of a SAH

Answer 21

1. Re-bleeding:sudden death, 2.Cerebral ischaemia

3. Hydrocephalus and 4.Hyponatraemia

Question 22

List the 3 factors that predispose to a subdural haemorrhage

Answer 22

1. Being elderly, 2. Alcoholics and 3. anti-coagulation disorders