Stroke Flashcards
WHat is a stroke?
A neurological deficit attributed to an acute focal injury of the CNS by a vascular cause, including cerebral infarction, intreacerebral haemorrhage and subarachnoid haemorrhage
WHat is a TIA?
Transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction
What are some of the preliminary exams for stroke diagnosis, what are they used fo?
CHADS2- Atrial fibrillation risks
ROSIER- identifies acutestroke
WHat percentage of strokes is ischaemic?
85%
WHat % of strokes is haemorrhagic?
10%
WHts is an example of an ischaemic stroke?
Thromboemblic
WHat is are examples of haemorrhagc=ic strokes?
Intracerebral
Subarachnoid
What are examples of other strokes?
Carotid artery
Venous sinus thrombosis
Hypoxic brain injury
Which pathologies are more likely to cause a stroke in young?
Vasculitis Thrombophilia Subarachnoid haemorrhage Venous sinus thrombosis Carotid artery dissection
WHat is one reason for carotid artery dissection?
Fibromuscular dyplasia
Which pathologies are more likely to occur in elderly?
Thrombosis in city Author- thromboembolism e.g. carotid arteries Heart emboli CNS bleed Sudden blood pressure drop Vasculitis Venous sinus thrombosis
What are heart emboli associated with?
Atrial fibrillation, infective endocarditis or MI
What are risk factors for stroke?
Hypertension Smoking Diabetes mellitus Heart disease Peripheral arterial disease Post- tia Carotid artery occlusion, carotid bruit Polycthemia vera COCP Hyperlipideamia Excess alcohol Clotting disorders
What does the anterior cerebral artery supply?
Lower limb, motor and sensory
What are the symptoms of anterior cerebral stroke?
Contralateral lower limb weakness Contralateral lower limb sensory deficit Urinary incontinence Split brain syndrome/alien hand syndrome Frontal lobe features
Describe urinary incontinence in ACA
Affects the paraccentral lobule within the cortex that excites the M centres, the micturition centres that then project parasympathetics to the detrusor for contraction
What are the frontal lobe features that can show
Personality changes
Apraxic problems e.g. buttoning shirt- motor planning
Which regions are likely to be affected in a middle cerebral artery stroke?
MCS SUPERIORI
MCA inferior
Lenticulostriate arteries
Internal carotid arteries
Where is a proximal MXA occlusion likely to occur?
Internal carotid
Which areas of the brain does the MCA supply?
Lateral frontal, parietal and temporal lobe
And internal capsule
Why does a a complete contralateral hemi paresis occurs in internal carotid artery stroke?
Because of the regions that the MCA supplies
Internal capsule is the reason for motor deficits throughout because just parietal would affect just the face and arm
What vision problems would be caused by an MCA stroke?
homonymous hemaniopia
Why is there a homonymous hemaniopia?
Destruction og superior and inferior optic radiation due to affect on parietal and temporal
What are the symptoms of proximal MCA occlusion?
Contralateral hemiparesis
Contralateral sensory deficit
Contralateral homonymous hemaniopia
