Stroke Pathology Flashcards Preview

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Flashcards in Stroke Pathology Deck (24)
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1
Q

What is a stroke

A

the experience of persisting neurological complications of cardiovascular disease
-NOT A DIAGNOSIS

2
Q

What is a TIA

A

A diagnosis based on clinical presentation and not pathology.
It is a brief episode of neurological dysfunction caused by focal brain or retinal ischaemia with symptoms lastin usually less than one hour and with no evidence of infarction
NOT BENIGN

3
Q

What are the two types of acute cerebrovascular syndrome

A

Ischaemic

Haemorrhagic

4
Q

How frequently are those who present with stroke ‘mimics’

A

one third of pts presenting may be ‘mimics’

5
Q

what score is used to help diagnose stroke

A

Rosier score

Score more than 0 suggests stroke is likely

6
Q

How long do stroke symptoms typically last

A

more than 24hours

7
Q

What is the oxford classification for cerebrovascular syndromes

A

Total anterior circulation syndrome
Partial anterior circulation syndrome
Lacunar syndrome
Posterior circulation syndrome

8
Q

What is TACS and how does it present

A

A stoke affecting the entire anterior circulation.
Hemiplegia w/ at east tow of face arm and leg +/- hemisensory loss
Homonymous hemianopia
Cortical signs (dysphasia, neglect)

9
Q

What is the sequelae of TACS

A

it is the most severe type of stroke

only about five percent of pts are alive and independent at one year

10
Q

What the clinical presentation of partial anterior circulation syndrome?

A

One of:

  • 2 out of 3 features present in a TACs
  • isolated cortical dysfunction such as dydphasia
  • pure motor/sensory signs less severe than in lacunar syndromes eg monoparesis
11
Q

what is the prognosis of PACS

A

55 percent alive and independent at one year

12
Q

What is a lacunar syndrome (LACS)?

A

lacunar infarcts are small infarcts in the deeper parts of the brain (basal ganglia, thalamus, white matter) and in the brain stem,
can affects any two of: face, arm or leg

13
Q

What causes a LACS

A

occlusion of a single deep penetrating artery.

14
Q

What is the prognosis of LACS

A

best prognosis

60 percent alive and independent at one year

15
Q

What is posterior circulation syndrome (POCS)

A
Affects posterior circulation
Presents with :
-cranial nerve palsies
-conjugate eye movement disorders
-isolated homonymous hemianopia
-cortical blindness
-cerebellar deficits without ipsilateral motor/sensory signs (in contrast to Ataxic hemiparetic lacunar syndrome)
16
Q

What is the POCS prognosis

A

good- one year survival almost 60 percent

17
Q

Which is the dominant and non dominant hemisphere in most people

A

dominant is left in most people and non dominant ir right in most people

18
Q

Event in which cerebral hemisphere usually cause problems with language

A

left

19
Q

Events in which cerebral hemisphere usually cause problems with spatial awareness

A

right

20
Q

what is the most common cause of stroke

A

Atherothromboembolism

21
Q

What cardiac condition gives a big increase in the risk of stroke

A

AF - five fold increased risk

22
Q

how many strokes are due to af

A

1 in 6

23
Q

What are the different types of haemorrhagic stroke?

A

Primary intracerebral haemorrhage - hypertension, amyloid angiopathy
Secondary intracerebral haemorrhage- arteriovenous malformation, aneurysm, tumour

24
Q

What are the findings on MRI of primary intracerebral haemorrhage.

A

If lobar= cerebral amyloid angiopathy

if deep= more likely to be blood pressure related