Clincal Considerations of stroke

Question 1

What is a stroke?

Answer 1

A neurological deficit related to an atraumatic vascular event

Question 2

What are the two types of stroke?

Answer 2

Ischaemic (90%)

Haemorrhagic (10%)

Question 3

What is a Trans Ischamic Attack (TIA)?

Answer 3

This is a ‘mini stroke’

A neurovascular event with symptoms that lasts for under 24 hours

Question 4

How do you calculate risk of a TIA becoming a stroke later down the line?

Answer 4

A - Age >60

B - BP >145 or <90

C Coordination ?hemiparesis or speech

D Duration

D Diabetes

Question 5

How do the symptoms of stroke work, including the eyes?

Answer 5

A stroke on one side will cause CONTRALATERAL symptoms

eg right sided stroke causes left hemiparesis and the same for homonymous hemianopia

right sided occipital stroke causes left homonymous hemianopia (a stroke behind the optic chiasm causes damage in both eyes)

Question 6

How do you know the underlying cause for symptoms such as hemiparesis is due to a stroke?

Answer 6

They come on acutely. This distinguishes it from nerve/muscle disease

Question 7

What is the Cushings Response Triad?

Answer 7

1. Raised BP
2. Low HR
3. Irregular breathing