Stroke Flashcards
(35 cards)
What are the main causes of stroke?
Small vessel occlusion, thrombosis in situ, cardiac emboli, atherothromboembolism, CNS bleeds
What imaging result can indicate cardiac emboli?
Bilateral infarcts
What cardiac condition can cause cardiac emboli?
Atrial fibrillation, MI, valve disease, IE
What are risk factors for an ischaemic stroke?
Age, male, HTN, smoking, DM, past TIA, heart disease, combined oral contraceptive pill
What clinical presentations suggest haemorrhage?
Meningism, severe headache, coma
What clinical presentations suggest a cerebral infarct?
Contralateral sensory loss, contralateral hemiplegia that’s initially flaccid but becomes spastic, dysphasia, homonymous hemianopia, visuo-spatial deficit, UMN facial weakness that’s forehead sparing
What clinical presentations suggest a brainstem infarct?
Quadriplegia, locked-in syndrome, facial numbness/paralysis, gaze/vision disturbances, dysarthria and speech impairment, altered consciousness
Where are lacunar infarcts?
Basal ganglia, internal capsule, thalamus, pons
What are the 4 clinical presentations that suggest a lacunar infarct?
Ataxic hemiparesis, unilateral motor weakness, sensory loss, dysarthria/clumsy hand
In which lacunar stroke is consciousness/cognition not intact?
Thalamic strokes
When would you do a diffusion-weighted MRI?
If diagnosis is uncertain
How would you check for a cardiac embolus?
ECG
What blood tests should you do?
Glucose, FBC, U&Es, Cholesterol, INR if on warfarin
How would you check for vasculitis?
ESR increased
What are some differential diagnoses?
Head injury, hypo/hyperglycaemia, subdural haemorrhage, Intracranial tumours, hemiplegic migraine, encephalopathy
How can you test perceptual function?
Point to a named part of the body
How can you test spatial ability?
Copying matchstick patterns
How can you test apraxia?
Dressing, copying a clock face
How can you test agnosia?
Picking out and naming easy objects from a pile
How can you monitor progress?
Time taken to sit up and transfer to a chair
What are some potential complications due to immobility?
Pressure sores, aspiration pneumonia, constipation, contractures
What primary prevention is there?
Control risk factors, exercise, lifelong anticoagulation AF and prosthetic heart valves
What secondary prevention is there?
Control risk factors, antiplatelets, anticoagulation after stroke from AF
What areas does Barthel’s index of activity of daily living cover?
Bowels, bladder, grooming, toilet use, feeding, transfer, mobility, dressing, stairs, bath/shower
