stroke pathology

Question 1

what is a stroke?

Answer 1

a sudden neurologic event of vascular origin

Question 2

describe the frequency of strokes by type

Answer 2

-infarction eg thrombo-embolic - 65% +
-haemorrhage - 12% subarachnoid or intracerebral
-TIA - 21%

Question 3

what are examples of risk factors for a stroke?

Answer 3

-hypertension
-smoking
atherosclerosis
-hyperlipidaemia (high amount of lipids in blood)
-diabetes
-thrombosis and embolism
-oral contraceptives
-obesity

Question 4

what risk factors can result in vessel wall damage?

Answer 4

-hypertension
-smoking
-athertosclerosis
-diabetes
-hyperlipidaemia

Question 5

what is a collateral circulation?

Answer 5

alternate or “backup” blood vessels in your body that can take over when another artery or vein becomes blocked or damaged. Your collateral circulation provides alternative routes for blood flow.

Question 6

how is stroke classified? - ASCO

Answer 6

A- Atherothrombosis
-S- Small vessel disease
-C - Cardioembolism
-O-Other causes

Question 7

what is middle cerebral artery occlusion ?

Answer 7

-occlusion / clot of the middle cerebral artery in the brain

Question 8

signs and symptoms of middle cerebral artery occlusion

Answer 8

-unilateral weakness (one side)
-facial droop
-speech deficits - could be mild to severe

Question 9

what is cerebral small vessel disease?

Answer 9

Cerebral small vessel disease (SVD) is an umbrella term covering a variety of abnormalities related to small blood vessels in the brain

Question 10

what is an important point to know about patient before manipulations in the neck area?

Answer 10

• they may have fibromuscular dysplasia

Question 11

what is fibromuscular dysplasia?

Answer 11

Fibromuscular dysplasia (FMD) is the abnormal development or growth of cells in the walls of arteries that can cause the vessels to narrow or bulge. The carotid arteries, which pass through the neck and supply blood to the brain, are commonly affected.

Question 12

what cardioembolic conditions could cause a stroke?

Answer 12

-endocarditis
-valvular heart disease
-patent foramen ovale ( a hole between the left and right atria (upper chambers) of the heart.)

Question 13

what is an intracerebral haemorrhage?

Answer 13

-bleeding in the brain caused by the rupture of a damaged blood vessel in the head.
-bleeding into the brain parenchyma (functional tissue in brain - neurone and glial cells)

Question 14

what causes an intracerebral haemorrhage?

Answer 14

-hypertension
-amyloid (extracellular deposits)
-aneurysm
-cavernoma
-drugs
-trauma

Question 15

what is an aneurysm?

Answer 15

abnormal bulge or ballooning in the wall of a blood vessel

Question 16

what is a cavernoma?

Answer 16

A cavernoma is a cluster of abnormal blood vessels, usually found in the brain and spinal cord

Question 17

what is a subarachnoid haemorrhage?

Answer 17

bleeding between the arachnoid and Pia mater meningeal layers around the brain

Question 18

what are the risk factors of subarachnoid haemorrhage?

Answer 18

-cigarettes
-hypertension

Question 19

what are examples of drugs that could trigger an intracerebral haemorrhage?

Answer 19

• cocaine
  -amphetamines (stimulant drugs)

Question 20

how is a stroke managed via end-vascular surgery?

Answer 20

-placing a catheter into the brain and removing the clot that’s causing the stroke.
-Endovascular therapy must be done within six to eight hours of the onset of a stroke

Question 21

how is stroke managed long term?

Answer 21

rehab
-physio
-speech and language
-OT