Flashcards in Stroke: Anatomy, causes/risk factors, clinical syndromes/investigations Deck (18)
Acute onset neurological symptoms/signs indicative of focal CNS dysfunction, from vascular cause (ishaemia/haemorrhage) >24hrs
2 types of stroke?
[- Arterial: AIS (acute ischaemic stroke) , Lacunar (slowly over time -> vascular dementia)
- Venous: central venous sinus thrombosis]
[- Arterial: aneurysm (causing SAH) , arterio-venous malformation, PICH (primary intra-cerebral haemorrhage), EDH, AIS
- Venous: SDH (subdural haemorrhage), CVST, cavernoma]
- Vessel-wall injury
What is a "silent stroke"
Right sided lesions can be a "silent stroke", as the left side is more critical for speech and language
Outcome of MCA infarct (clinical syndrome)
Hemiplegia (typically pts walk w/ arm flexed and leg extended)
Outcome of ACA infarct (clinical syndrome)
leg weakness > arm weakness (due to motor homunculus)
Outcome of PCA infarct (clinical syndrome)
Homonymous hemianopia (e.g. right occipital lobe damage -> can't see left hand side of each eye)
What is an endartery?
No collateral circulation- it is the only artery supplying that region of the brain and cannot be replaced
Cognitive syndromes post stroke (left hemisphere damage) + what brain lobe?
aphasia, apraxia (temporo-parietal)
Cognitive syndromes post stroke (right hemisphere damage) + what brain lobe?
neglect/ inattention (fronto-parietal)
Cognitive syndromes post stroke (frontal) + what brain lobe?
apathy, dysexecutive syndrome (Frontal Lobe Right/Left damage)
Posterior Inferior Cerebellar Artery (PICA) infact outcome?
ataxia in one limb, Horner’s syndrome, cranial nerve palsy
[Stroke pathology] outcome of thromboembolism
[Stroke pathology] outcome of hypoperfusion i.e. complete blockage of an artery
infarction in “watershed zone” (area furthest away from each arterial branch)
infarction of small deep penetrating artery
caused by: HTN, ageing , diabetes, renal disease, migraine; (rare: CADASIL)
can result in dementia/parkinsonism
In a stroke, damage to the ___ is usually irreversible
However damage to the ___ is potentially reversible
In a stroke, damage to the core (in middle) is usually irreversible
However damage to the penumbra (i.e. area surrounding the core) is potentially reversible
Cerebral blood flow thresholds based on the core-penumbra model
<10 ml/100g/min: necrosis (irreversible)
10-20 ml/100g/min: reversible e.g. w/ tPA
35-50 ml/100g/min: normal brain