Stroke Lecture 1

Question 1

What is Stroke?

Answer 1

Rapid loss of brain function due to disturbances in the blood supply

Question 2

What are the causes of stroke ?

Answer 2

Ischemia and Hemorrhage

Question 3

What is an Ischemia?

Answer 3

lack of blood supply to the brain

Question 4

What is a Hemorrhage?

Answer 4

Burst of a blood vessel

Question 5

What happens to where the stroke occurs?

Answer 5

The affected area of the brain cannot work properly

Question 6

What are the effects of a Stroke (6)?

Answer 6

Movement (Paralysis to one side
Speech and Language
Eating and Swallowing
Vision
Cognition
Perception

Question 7

What is Hemiparesis

Answer 7

Paralysis to one side of the body

Question 8

What is the prevalence of Stroke (Epidemiology)

Answer 8

Second Leading cause of mortality
50% end up with permanent disability
1/5 will have a stroke in their lifetime

Question 9

What is the energy consumption of the brain?

Answer 9

largest source of energy in body
20% of oxygen
50% of glucose

Question 10

What is vascular dementia?

Answer 10

Mismatch between cerbral blood flow and metabolic demand

Question 11

Why is the brain vulnerable to Ischemia

Answer 11

High energy requirements compared to low energy reserves, makes the brain vulnerable to lack of blood supply

Question 12

What does “Time is Brain” mean ?

Answer 12

Blood flow should be restored asap, to prevent rapid irreversible damage

Question 13

What is an Ischemic Core?

Answer 13

Ireversibly damaged area.
Blood and oxygen flow are severely diminished resulting in neuronal death

Question 14

What is the Penumbra

Answer 14

Reversible injured brain tissue, surrounding irreversible ischemic core

Question 15

How long are Ischemic penumbra cells viable for

Answer 15

6h-3 days

Question 16

What is the subacute phase of stroke

Answer 16

6-11 days. if cells are untreated during this time the penumbra succumbs to cell death

Question 17

What is Necrosis

Answer 17

Cell death

Question 18

What is infarctation

Answer 18

Tissue death due to lack of blood supply

Question 19

Complication of Stroke

Answer 19

Edema

Question 20

What is Edema

Answer 20

Brain swelling that can develop 24-48 h after stroke—– reaches peak 2-5 days after onset stroke

Question 21

What is ICP

Answer 21

Increased Intracranial Pressure- rise of pressure inside the skull (brain tissue cannot expand)

Question 22

What is an Ischemic Stroke

Answer 22

A blood clot or other blockages causing a decrease in blood flow to brain

Question 23

What causes an Ischemic Stroke ?

Answer 23

Thrombosis and Embolism

Question 24

What are the symptoms of an ischemic stroke

Answer 24

Sudden numbness or weakness of face, arm or leg
Sudden confusion, trouble speaking, vision problems
Sudden trouble walking

Question 25

What is the therapy for an Ischemic Stroke

Answer 25

Thrombolysis(dissolving of blood clot) Mechanical Thrombectomy Aspirin Anticoagulants (warfarin) Statins Antipyretics Neuronprotection (anti-inflammatory)

Question 26

What is a Hemorrhagic Stroke

Answer 26

Weakened vessel ruptures and bleeds into the surrounding brain

Question 27

What are the causes of Hemorrhagic Stroke

Answer 27

High blood pressure Ruptured aneurysm Head injuries Bleeding disorders

Question 28

What are the symptoms of a Hemorrhagic Stroke

Answer 28

Similar to Ischemic-- Causes severe sudden headache and stiff neck due to subarachnoid bleeding

Question 29

What is the therapy for Hemorrhagic Stroke ?

Answer 29

Surgical Clipping/Coil embolization Medicines to reduce intracranial pressure (osmotic diuretics) bp management

Question 30

What is the likelyhood of a stroke reoccuring

Answer 30

30% of strokes are reoccurent

Question 31

What are anticoagulants

Answer 31

slow down blood clotting

Question 32

What are anitplatelets

Answer 32

to prevent blood clotting

Question 33

What two pairs of vessels supply the brain with blood

Answer 33

Internal Carotid arteries Vertebral Arteries

Question 34

Where do the internal carotid and vertabral arteries connect

Answer 34

in the cranial cavity to create the CIRCLE OF WILLIS

Question 35

What does the internal carotid arteries supply

Answer 35

anterior blood supply of the brain

Question 36

What do the vertebral arteries supply

Answer 36

posterior blood supply of the brain

Question 37

What is the anatomy of the interal carotids

Answer 37

Begins at the Carotid Bifurcation on either side of the neck Each artery travels up through the neck to base of skull Goes through opening in skull known as CAROTID CANAL Connects with the CIRCLE OF WILLIS Terminate middle and anterior cerebral artery The anterior cerebral arteries are connected by the anterior communicating artery

Question 38

What makes up anterior circulation

Answer 38

The interal carotids and their branches

Question 39

What are the branches of the internal carotid

Answer 39

anterior cerebral arteries middle cerebral arteries

Question 40

What happens when there is an anterior circulation stroke

Answer 40

Unilateral weakness Dysphasia Visual Field Defects

Question 41

What is the anatomy of the vertebral arteries

Answer 41

Originate in subclavian area enter skull through foranum magnum Two vertebral arteries join to form basilar artery and connect to the CIRCLE OF WILLIS Terminates by ifurcating into posterior cerebral arteries

Question 42

What is the anatomy of the external carotids

Answer 42

Begin at the carotid bifurcation on neck Travel along neck up to ears Near ear, it divides into its two terminal branches: maxillary artery and superficial temporary artery

Question 43

What is the function of the external carotid

Answer 43

Blood supply to face and neck area

Question 44

What are meninges

Answer 44

Connective Tissue membranes which ensheath the brain and spinal cord

Question 45

What is the function of the meninges

Answer 45

protect brain and achor in bone cavity

Question 46

What are the three layers

Answer 46

Dura mater Arachnoid Mater Pia Mater

Question 47

epidural/extradural Space

Answer 47

potential space between dura mater and bone

Question 48

Subdural space

Answer 48

potential space between arachnoid and dura mater

Question 49

Subarachnoid Space

Answer 49

potential space between arachnoid mater and pia mater

Question 50

What are the types of intracranial bleeding

Answer 50

Intra axial extra-axial

Question 51

Intra- axial bleeding

Answer 51

bleeding in the brain

Question 52

Extra-axial bleeding

Answer 52

outside the brain but within the skull

Question 53

What are the three types of extra-axial haemorrhages

Answer 53

Epidural Haemorrhage Subdural Haematoma Subarachnoid

Question 54

Epidural Haemorrhage

Answer 54

bleeding between dura mater and the skull

Question 55

Subdural Haematoma

Answer 55

bleeding in the subdural space

Question 56

Subarachnoid Haemorrhage

Answer 56

Bleeding between the arachnoid and pia mater