Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

4th Year > Stroke > Flashcards

Stroke Flashcards

(55 cards)

Start Studying
1
Q

what is the window for reversal in thrombolysis and thrombectomy

A

thrombolysis 4.5hrs

thrombectomy 6 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how is a scan diagnosed

A

acute onset
focal neuropathy
imaging to rule out other presentations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is an intracranial bleed

A

NOT A STROKE
extradural/subdural/subarachnoid
causes neurosigns due to compreesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is an intracerebral bleed

A

haemorrhagic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when is neurosurgery used in haemorrhagic strokes

A

to relieve compression- will not relieve disability

will only do when risk to life (coning, obstructive hydrocephalus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

causes of haemorrhagic stroke

A

blood- anticoagulants/platelets, excessive bleeding
vessel- HTPN, atherosclerosis, vasculitis, aneurysms, AVM, amyloid angiopathies
extravascular- bleeding into a tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what type of stroke does atherosclerosis cause

A

ischaemic (high cholesterol/diabetes causes formation of atheromas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what type of stroke does arteriosclerosis cause

A

haemorrhagic stroke

thickening of lumen (middle layer) due to HPTN (calcification)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name stroke mimics

A

migraine, post seizure focal deficits, hypoglycaemia, acute presentation of SOL, bells palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which carotid supplies anterior circulation

A

internal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which artery supplies posterior circulation

A

vertebral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does the circle of willis provide

A

collateral blood supply when blockage occurs - if acute blockage occurs before circle of willis will not be able to compensate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the cortex if the brain

A

outermost part
grey matter
has communicating vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the cerebral medulla

A

the inner part of brain
white matter (axons)
has non communicating vessels (if occluded no collateral)- perforating arteries (are end arteries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is causes when a cerebral artery is blocked

A

large artery occlusion- grey and white natter will die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what happens when a perforating artery is blocked

A

deep infarct, small artery occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does the internal carotid divide into

A

anterior and middle cerebral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the basilar artery

A

formed from vertebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what does the basilar artery divide into

A

posterior cerebral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is a embolus

A

a thrombus that occludes an artery distal to where it was formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is a thrombus

A

blocks artery where it was formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

is an embolus or thrombus more likely to cause a stroke

A

embolus

thrombus forms slowly, large vessels have collaterals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

are large vessel infarcts usually embolic or thromobic

Study These Flashcards
A

embolic (needs acute occlusion due to collateral vessels)

24
Q

do embolic strokes usually affect cortex or medulla

25
what should you think when there is multiple infarcts in multiple locations
source- e.g. heart
26
what are the cortical signs of a stroke
dominant hemisphere: (usually left, controls communication) - dysphagia (expressive understand cant express, receptive fluent but cant understand- usually mixed) -agnosia (cant recognise objects) right hemisphere -hemispatial neglect -personality changes -sensory inattention
27
what can cause a pure motor stroke
large vessels embolic cortical OR small vessel thrombotic deep infarct
28
what causes a wedge shaped infarct
embolic large vessel occlusion
29
what causes just a hand/leg motor stroke
thrombotic small vessels deep infarct in internal capsule
30
what is a TACS
total anterior circulation stroke
31
what are the features of a TACS
hemiparesis hemisensory loss hemianopia higher cerebral dysfunction (cortical signs)
32
what causes a TACS
embolus (large vessel) | could also be a large lobar bleed
33
what is a PACS
partial anterior circulation stroke
34
what are the features of a PACS
can be isolated in cortex (Cortical signs) or can have any 2 features of TACS (usually cortical + hemi symp) need to have cortical as this shows is an embolic large vessel block
35
what causes a PACS
large vessel embolus
36
what is a POCS
posterior circulation stroke
37
what are the features of a POCS
``` brain stem- syncope occipital lobe- visual disturbance, hemianopia (isolated) pariatal lobe- sensory cerebellum- ataxia, diplopia low MN facial weakness ```
38
what causes a POCS
embolic/thrombotic in vertebral basilar artery | if isolated hemianopia then embolic
39
what is a LACS
lacunar stroke
40
what are the features of a LACS
``` pure physical (ataxic hemiparesis if occurs in internal capsule, if anywhere else may go unnoticed) pure sensory ```
41
what causes a LACS
small deep vessels thrombosis
42
do you get cortical signs in a LACS
no
43
what usually causes large vessel stokes
atheroembolic
44
what can cause a stroke in infants
dissection (only painful stroke) | hypoperfusion - causes watershed infarcts between two artery territories)
45
what is a venous infarct
blockage in IJV causes brain swelling and haemorrhage due to back pressure (Tx anticoagulation)
46
what is a paradoxical embolism
when hole in heart means DVT goes to brain (Tx thrombolysis, anticoagulation and 2ndary prevention)
47
what is a TIA
true TIAs only last few minutes if hours then stroke with neuroplasticity need urgent Ix and Tx as most recovery to gain and high risk of recurrence
48
what are the IX for stroke
``` blood- general, lipids, glucose ECG- AF carotid doppler -ambulatory monitoring -PAF ECHO- AF, mitral/aortic valve disease CT best for acute haemorrhage (all Pts get CT), doesnt always show infarct but diagnosis is clinical anyway - use CT to find contraindication to thrombolysis if cant tell after 1-2 weeks if ischaemic/haemorrhagic do MRI if TIAS do MRI if possible ```
49
what are the indications for a carotid endartectomy
stenosis >70% in stroke causes artery/ >50% in young males NOT DONE IN ASYMPTOMATIC ARTERY EVEN IN >80% AS RISK OF STROKE needs to be within 14 days of TIA/stroke
50
what is the treatment for venous clots
anticoagulation
51
what is the treatment for arterial clots
antiplatelets
52
what strokes can hyperacute treatments be used for
ischaemic
53
what are the hyperacute treatments and when can they be used
thrombolysis- within 4.5 hrs (risk of haemorrhagic transformation after), aim to reduce disability (cant reverse stroke) thrombectomy- 6 hrs, only for large vessel proximal occlusions (ICA), need CT angiogram
54
what is the secondary prevention following strokes
antiplatelet-75 mg clopidogrel (aspirin if CI, dual if high risk) anticoagulants- TIAs start day 1, large infarcts 1-14 days later to prevent haemorrhage, use aspirin 300mg in interim statins (only for atherosclosis: 20-80mg antiHPTNsives (HPTN biggest RF for stroke, very important to control in acute setting for haemorrhagic strokes) diabetic/ lifestyle management MDT rehab
55
Tx pathway for stroke and TIA
300mg aspirin when suspected, continue for 2 weeks (offer PPI CT for stroke for TIA only CT if considering other diagnosis, consider MRI. Do carotid doppler for TIA. Carotid endarectomy for TIA and non disabling stroke with stenosis >50/70% ischaemic stroke: thrombolysis with alteplase within 4.5 hours thombectomy with thrombolysis, if within time frame, within 6 hours venous sinus thrombosis: anticoag: heparin and then warfarin haemorrhagic stroke: Bp control if hypertensive

4th Year (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions