Stroke:pathology and investigation

Question 1

What is a stroke?

Answer 1

Neurological deficit of sudden onset lasting more than 24 hrs of vascular origin

Question 2

What is a Transient ischaemic attack?

Answer 2

less than 24hrs
neuro deficit
of vascular origin

Question 3

What are the symptoms of stroke?

Answer 3

• Lose of power
• Loss of sensation
• Loss of speech
• Loss of vision
• Loss of coordination

Question 4

What does photophobia suggest?

Answer 4

haemorrhage

Question 5

What is dysarthria

Answer 5

the muscles you use for speech are weak or you have difficulty controlling them

Question 6

What is dysphasia?

Answer 6

language disorder marked by deficiency in the generation of speech, and sometimes also in its comprehension, due to brain disease or damage

Question 7

What is nystagmus?

Answer 7

“jiggly eyes” rapid jerking movements

Question 8

What causes a stroke?

Answer 8

Blockage of a blood vessel by thrombus or embolus to brain
OR
due to haemorrhage

Question 9

What links anterior and posterior circulation of the brain?

Answer 9

Circle of Willis

Question 10

What does the carotid system supply?

Answer 10

Most of the hemispheres and cortical deep white matter

Question 11

What does the vertebro-basilar system supply?

Answer 11

Brain stem

cerebellum and occipital lobes

Question 12

What is frontal lobe responsible for?

Answer 12

Judgement
foresight
Voluntary movement

Question 13

What is Broccas area responsible for?

Answer 13

Speech

Question 14

What is the temporal lobe responsible for?

Answer 14

intellectual and emotional functions

Question 15

What is the brainstem responsible for?

Answer 15

Swallowing
Breathing
heartbeat
wakefulness centre and other involuntary functions

Question 16

What is the cerebellum responsible for?

Answer 16

Co-ordination

Question 17

What is wernicke`s area responsible for?

Answer 17

Speech comprehension

Question 18

What is the occipital lobe responsible for?

Answer 18

Primary visual area

Question 19

What is the temporal lobe also responsible for?

Answer 19

Hearing

Question 20

What is the parietal lobe for?

Answer 20

Comprehension of language

Question 21

What is the sensory cortex responsible for?

Answer 21

Pain heat and other sensations

Question 22

In deep white matter where will a stroke be most devasting and why?

Answer 22

The internal capsule
and Pons

Major effect as fibres are packed close together

Question 23

What are the 4 causes of a stroke?

Answer 23

• Blockage of a vessel with clot or thrombus
• Disease of vessel wall
• Disturbance of normal properties of blood
• Rupture of vessel

Question 24

What is the commonest cause of a cardioembolic stroke?

Answer 24

Atrial fibrilation

Question 25

What is a small vessel of a stroke called?

Answer 25

Lacunar

Question 26

What are the rarer causes of a stroke?

Answer 26

Carotid dissection (idiopathic or stroke)

Question 27

What are the subtypes of stroke?

Answer 27

- TACS: Total anterior circulation stroke - PACS: Partial anterior circulation stroke - LACS: LAcunar stroke - POCS:Posterior circulation stroke

Question 28

What does left optic nerve compression result in?

Answer 28

Unilateral field loss

Question 29

What does chiasmal compression from pituitary tumour/thrombus

Answer 29

Bitemporal hemianopia

Question 30

What does left cerecrovascular event result in?

Answer 30

Homonymous hemianopia

Question 31

What percentage of strokes TACS?

Answer 31

20%

Question 32

What are the symptoms of a TACS?

Answer 32

``` Weakness sensory deficit Homonymous hemianopia (loss of vision) Higher cerebral dysfunction (dysphasia, dyspraxia) ```

Question 33

What is TACS usually caused by?

Answer 33

Occulsion of proximal middle cerebral artery or ICA

Question 34

What percentage of strokes are PACS?

Answer 34

35%

Question 35

What are the symptoms of a PACS?

Answer 35

- One limb - Face and hand - higher cerebral dysfunction (2/3 of the above)

Question 36

What causes PACS?

Answer 36

Middle Cerebral Artery

Question 37

What percentage of strokes are LACS?

Answer 37

20%

Question 38

What are the four types of LACS?

Answer 38

- Pure motor - Pure sensory - Sensorimotor - Ataxic hemiparesis

Question 39

Describe a pure motor LAC?

Answer 39

Complete or incomplete weakness of 1 side, involving the whole of 2 of 3 body areas (face/arm/leg)

Question 40

Describe a pure sensory LAC?

Answer 40

Sensory symptoms involving the whole of 2/3 body areas

Question 41

Describe an ataxic hemiparesis LAC?

Answer 41

Hemiparesis and ipsilateral cerebellar ataxia Small infarcts in basal ganglia or pons. Intrinsic disease of single basal perforating artery (end arteries).

Question 42

What is ataxia?

Answer 42

Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that includes gait abnormality.

Question 43

What percentage of strokes are POC`s?

Answer 43

25%

Question 44

What is affected during POCs?

Answer 44

Brainstem,cerebellar or occipital lobes

Question 45

What is the normal presentation of POCS?

Answer 45

There is none ahahahaha variable and complex

Question 46

What are the modifiable risk factors for a stroke?

Answer 46

- High blood pressure | - Atrial fibrillation

Question 47

What are the non-modifiable risk factors for stroke?

Answer 47

- Age - Race - Family history