Ischaemic Stroke

Question 1

Types of stroke

Answer 1

Ischaemic stroke = blocked artery

Haemorrhagic stroke= artery breaks

Question 2

More common stroke

Answer 2

Ischemic

Question 3

Damage depends on

Answer 3

Location and time

Question 4

If symptoms resolve in 24 hours then it is a?

Risk is?

Answer 4

Transient ischemic attack

Minimal long term damage

Question 5

Right cerebrum controls ?

Answer 5

Muscles on left side of the body and vice versa

Question 6

Function of lobes

Answer 6

Frontal- movement /executive function

Parietal- sensory info

Temporal - hearing, smell, memory, language, facial recognition

Occipital- vision

Cerrebellum- muscle coordination + balance

Brain stem- HR, BP, Breathing, GI, consciousness

Question 7

Back of brain supplied by

Answer 7

Basilar artery

Question 8

Vertebral artery (internal carotid artery) supplies

Answer 8

Frontal+ parental parts of the brain

Question 9

Brain arteries connected by

Answer 9

Circle of Willis

Question 10

Collateral circulation

Answer 10

Blood can flow around circle of Willis to provide blood for any part of the brain that is under supplied

Can overcome gradual blockage

Question 11

Endothelial cell dysfunction ? Explained

Answer 11

IritNts damage endothelium (tobacco)

Damage site becomes site for artherosclerosis

Plaque forms and obstructs blood flow

Question 12

Most common sites for atherosclerosis

Answer 12

Branch points of the internal carotid + middle cerebral arteries

Question 13

Which plaques are more dangerous

Answer 13

Small plaques

Fibrous cap ripped off

Thrombogenic plaque left behind

Within a minute the artery can be duly blocked

Question 14

2 ways of ischemic stroke

Answer 14

Endothelial cell dysfunction

Embolism

Question 15

Embolism explained

Answer 15

Blood clot breaks off and gets lodged in another location

Question 16

What causes stagnant blood

Answer 16

AF OR MI

Question 17

What does stagnant blood form

Answer 17

Blood clot

Question 18

Blood clot in left atrium leads to

In right vertical leads to

Answer 18

Left = brain

Right= lungs

If septal defect then clot can go to any side

Question 19

Lacunar stroke most commonly where

Answer 19

Middle cerebral artery deep branches

Damaged brain forms cysts that look like lakes

Question 20

Lacunar cysts form due to

Answer 20

Hyaline arteriosclerosis

Question 21

When 02 diminished in body for any reason what happens

Answer 21

Up have a watershed infarct in your brain

Question 22

Ischemic Core

Answer 22

Tissues die due to ischemia

Question 23

Ischemic penumbra

Answer 23

Preserved by collateral circulation may survive I’d restored early enough

Question 24

High NA

+ high CA2+ means what in cells

Answer 24

NA = oedema

Ca2+= reactive oxygen species

Damaged mitochondria + lysosome release apoptosis inducing factors

Question 25

Inflammation does what

Answer 25

Damages the blood brain barrier Fluid + protein enter brain (Vasogenic edema)

Question 26

Swollen brain means

Answer 26

Swollen tissue push into the unaffected side of the brain Causing cingulate/ uncalled herniation Or slips out of base of skull (cerebellar tonsil herniation) Can push into brainstem and affect breathing + consciousness

Question 27

Stroke in Anterior /middle cerebral artery Broca region Wernickes area Posterior cerebral artery stroke

Answer 27

Numbness/swollen muscles weakness Slurred speech Difficulty understanding speech Vision

Question 28

Stroke symptoms s

Answer 28

FAST Face droop Arm weakness Speech difficulty time to get help quick

Question 29

Diagnosis

Answer 29

Ct or mri Angiography to look at where blood is Flair to distinguish old stroke from new

Question 30

Treatment

Answer 30

Thrombolectic enzymes TPa (activates clotting enzymes) has time limit for usage Aspirin- prevents clotting Surgery if TPA doesn’t work

Question 31

Minimise risk how

Answer 31

Quit smoking Healthy bp Normal LDL cholesterol Control diabetes

Question 32

Surgical treatments

Answer 32

Clean attires Carotid endarterectomy Stent - placed to keep artery open