stroke Flashcards
(19 cards)
what is a stroke?
It is an acute onset of focal neurological symptoms and signs due to disruption of blood supply.
what are the two types of stroke?
haemorrhagic
- ischaemic - more common
what normally causes haemorrhagic stroke ?
- hypertension
what does hypertension do to the vessel walls ?
it weakens it
what can weaken the vessel walls?
structural abnormalities like aneurysm, arteriovenous malformation
inflammation of the vessel wall (vasculitis
As you get older blood vessels become less ____ and so may be unable to cope with high ___
As you get older blood vessels become less elastic and so may be unable to cope with high blood pressure
ischaemic stroke can be due to
- thrombus
- embolus
- hypoperfusion
what are some non-modifiable risk factors for stroke?
- age - biggest one
- family history
- gender
- race
- previous stroke
what are some potentially modifiable risk factors? main ones
- hypertension - systolic
- history of TIA
- hyperlipidaemia
- smoking
what are some potentially modifiable risk factors? other ones
- Diabetes
- Atrial fibrilation
- Congestive heart failure
- Alcohol excess
- Obesity
- Physical inactivity
- Poor socioeconomic status
what are some non-cardiac causes of stroke?
- small vessel occlusion
- cardiac emboli
- atheroembolism
- ## CNS bleeds
what are some cardiac causes of stroke ?
- cardiac emboli
- Non valvular AF
- external cardioversion
- prosthetic valves
- acute MI
- paradoxical systemic emboli
- cardiac surgery
Valve vegetations from SBE/IE
how can prosthetic valves cause emboli?stroke
risk of emboli
how can MI cause stroke?
large left ventricle wall motion abnormalities on echocardiography predispose to left ventricular thrombus.
what are some other causes of stroke ?
- Homocysteinemia
- Vasculitis, Antiphospholipid antibody syndrome
- Protein S, C, Antithrombin III deficiency
- Paradoxical embolism through patent foramen ovale/pulmonary AV shunts
- Genetic- Factor V Leiden mutation, common prothrombin mutation, MELAS, -CADASIL,Fabry’s disease
- Cardioembolic- mural thrombi, infective endocarditis, myxoma
- Cervical artery dissection
what is a TIA?
essentially it is the same as a stroke
Blood vessels are built in such a way so that they can deal with a clot - every blood vessel has ____ (i think this is capable of breaking down clots)
tpa
If you have a small clot in the vessels this may be enough to cause symptoms (____) but the enzyme will eat away at it
If you have a small clot in the vessels this may be enough to cause symptoms (TIA) but the enzyme will eat away at it
what are the 6 essential questions for stroke?
1) Is this a stroke ?
2) What kind of stroke is this ?
3) What caused this stroke/TIA?
4) Have I tried my best to answer question 3 ?
5) Is the patients on the appropriate secondary prevention following investigations
6) Have I answered any questions the patient has ?
