Stroke

Question 1

What is an atheroembolic stroke?

Answer 1

Infarction in the perfusion territory of an extra cranial or intracranial artery (e.g. carotids) with >50% stenosis, with no other likely cause of stroke.

Question 2

Unilateral visual field loss would suggest ischaemia in which arteries?

Answer 2

Carotid or vertebrobasilar

Question 3

What is aphasia?

Answer 3

Impairment in any language function, either expressive or receptive.

Question 4

Which imaging modality is preferred in the acute setting?

Answer 4

CT; more sensitive to blood, along with being easier and quicker to access.

Question 5

Why should hypertension not be treated in these patients?

Answer 5

To maintain cerebral perfusion

Question 6

Which 3 blood tests are indicated in these patients?

Answer 6

• FBC; exclude thrombocytopenia.
• Clotting; rule out coagulopathy as a cause of haemorrhage.
• Cardiac enzymes; stroke may be associated with a concomitant MI.

Question 7

What does CHADSVAS stand for and what is its use?

Answer 7

Assess stroke risk in those with AF.

• Congestive HF
• Hypertension
• Age >75
• DM
• Stroke/TIA
• Vascular disease
• Age (65-74)
• Sex (i.e. female)

Question 8

What does HASBLED stand for and what is its use?

Answer 8

Estimate risk of major bleeding for patients on anticoagulation to assess risk-benefit in care of AF.

• Hypertension
• Abnormal renal/liver function
• Stroke
• Bleeding
• Labile INRs
• Elderly (e.g. >65y/o)
• Drugs or alcohol