Flashcards in Stroke & TIA Deck (16):
How is a stroke clinically diagnosed?
-Focal neuro deficit
-Of presumed vascular origin
-Symptoms lasting 24hrs+ or death
-TIA= symptoms less than 24hrs
What are the 2 types of stroke
What is the pathophysiology of acute ischaemic stroke?
-Initial reduction in cerebral blood flow
-Alterations in cellular chemistry caused by ischaemia
Describe cerebral metabolism
-Glucose is the sole substrate for energy metabolism
-Glucose is metabolised by glycolytic sequence & tricarboxylic acid cycle
-Neurons require constant supply of ATP to maintain integrity-cannot be stored
What are causes of ischaemic stroke?
-Thrombosis= large (extra-cranial) & small (intra-cranial) arteries
-Embolism= from heart (cariogenic-AF) & proximal arteries (artery to artery)
Which artery occlusion has the highest mortality/disability rate?
Proximal anterior circulation in ischaemic stroke
How do stents work?
1) Place stent across occlusion-leave for 10mins
2) Reperfuse brain
3) Most cot will lyse neutrally/impove efficacy
4) Withdraw stent with small clot core
What are the causes of a TIA?
-Carotid artery disease/large artery disease
-Cerebral small vessel disease
What can a TIA mimic?
-Acute confusional states
What are signs of an anterior circulatory TIA?
What are signs of a posterior circulatory TIA?
What are signs of either an anterior or posterior circulatory TIA?
-Visual field defects (hemianopia)
How can risk be assessed for stroke/TIA?
-A= Age (above 60=1)
-B=BP (above 140/90=1)
-C=Clinical features (unilateral weakness=2, speech=1)
-D=Duration of symptoms (60+mins=2, -10mins=0)
What is in a polypill?
What type of surgery is used for secondary vascular prevention?