Ischaemic stroke Flashcards
Causes for interruption to blood supply in an ischaemic stroke?
Embolus formation e.g. AF
Atherosclerosis
Shock
Vasculitis
TIA definition
transient neurological dysfunction secondary to ischaemia without infarction (resolves within 24 hours)
What is a crescendo TIA?
Where 2 or more TIAs occur in one week
What do SUDDEN onset of symptoms suggest?
A vascular cause
Stroke symptoms (4)
Are they typically symmetrical or asymmetrical?
B- balance
E- eyes (blurred vision)
F- facial drooping
A-arm/leg weakness
S- speech difficulty
Usually asymmetrical
Stroke risk factors
CVD (angina, MI, PVD)
Diabetes
Smoking
Hypertension
AF
Carotid artery disease
Relative with stroke
Vasculitis
Thrombophilia
Combined contraceptive pill
What scoring tool is used to detect stroke in A&E?
Minus points? (2)
Plus points (5)
What score indicates a stroke?
ROSIER
Seizure activity (-)
LOC or syncope (-)
Acute onset of:
Asymmetric facial weakness (+)
Asymmetric arm weakness (+)
Asymmetric leg weakness (+)
Visual field defect (+)
Speech disturbance (+)
Score over 0= stroke is likely
Stroke management
Exclude hypoglycaemia
Head CT to rule out haemorrhagic
Aspirin 300mg stat and continued for 2 weeks
If within 4.5 hours–> thrombolysis with alteplase
If within 24 hours–> thrombectomy
Should you lower, keep the same, or higher blood pressure?
Don’t lower blood pressure as this can risk brain hypoperfusion
TIA management?
Start aspirin 300mg daily
Secondary prevention of CVD
Imaging for a stroke?
Head CT–> shows a black area if ischaemic
Diffusion weighted MRI–> shows the vascular territory affected
Secondary prevention of a stroke? (2 meds, conditions to treat, surgical intervention?)
Clopidogrel
Statin
Treat HTN and diabetes
Carotid endarterectomy/stenting if CAD
