Stroke Flashcards
What is a stroke?
Rapidly developing clinical symptoms and signs of focal (sometimes global) loss of brain function
Symptoms >24 hours or leading to death
Vascular origin
What is a TIA?
Stroke <24 hours
What causes an intracerebral haemorrhage (leading to stroke)?
Structural abnormality
Hypertension
Amyloid angiopathy (friable blood vessels)
What are the types of infarcted stroke?
Atheroembolic
Cardioembolic
Small vessel disease
What causes an atheroembolic stroke?
Platelet dependent - white thrombus
What causes a cardioembolic stroke?
Fibrin dependent - red thrombus
What causes small vessel disease (leading to stroke)?
Arteriosclerosis
A fib
Microatheroma (do carotid scan)
How are cerebral infarctions classifed by the oxford community stroke project criteria?
Total anterior circulation infarct (TACI)
Partial anterior circulation infarct (PACI)
Lacunar infarct (LACI)
Posterior circulation infarct (PACI)
What are functions of the frontal lobe?
Personality
Emotional response
Social behaviour
What does a lesion in the frontal lobe cause?
Disinhibition Lack of initiative Antisocial behaviour Impaired memory Incontinence Grasp reflexes Anosmia
What are the functions of the dominant parietal lobe?
Calculation
Language
Planned movement
Appreciation of size, shape, weight and texture
What does a lesion in the dominant parietal lobe cause?
Dyscalculia Dysphasia Dyslexia Apraxia Agnosia Homonymous hemianopia
What are the functions of the non-dominant parietal lobe?
Spatial orientation
Construction skills
What does a lesion in the non-dominant parietal lobe cause?
Neglect of non-dominant side Spatial disorientation Constructional apraxia Dressing apraxia Homonymous hemianopia
What is the function of the occipital lobe?
Vision
What would a lesion in the occipital lobe cause?
Homonymous hemianopia
Hemianopic scotoms
Visual agnosia
Impaired face recognition (prosopagnosia)
Visual hallucinations (lights, lines, zig-zags)
What are the functions of the dominant temporal lobe?
Auditory perception
Speech, language
Verbal memory
Smell
What would a lesion in the dominant temporal lobe cause?
Dysphasia Dyslexia Poor memory Complex hallucinations (smell, sound, vision) Homonymous hemianopia
What are the functions of the non-dominant temporal lobe?
Auditory perception
Music, tone sequences
Non-verbal memory (faces, shapes, music)
Smell
What would a lesion in the non-dominant temporal lobe cause?
Poor non-verbal memory
Loss of musical skills
Complex hallucinations (smell, sound, vision)
Homonymous hemianopia
What are investigations for stroke?
CT scan MRI scan (better for infarct) Carotid scan Angiogram ECG/ 24 hr tape ECHO
What are risk factors for stroke?
Lipid profile
BP
Glucose
Smoking
What is management of stroke?
Thrombolysis/ thrombectomy - gold standard is IV tPA e.g. alteplase
Swallow assessment
Antiplatelets
Stroke unit care
In what time frame should IV tPA be given after stroke?
<4.5 hours from onset of symptoms
