Strokes Flashcards
(52 cards)
What are some common risk factors for strokes
What are the treatment options for an acute srtoke?
What is primary vs secondary prevention of strokes
How do we investigate strokes?
WHat order risk factors: Hypertension Current Smoker Waist-to-hip ratio Diet risk score Not Regular Physical activity Diabetes Alcohol intake Stresst depression Cardiac causes Ratio ApoB to ApoA
Hypertension - 52(%) Not regular Physical Activity 29 Waist to Hip ratio 27 Ratio ApoB to ApoA 25 Current Smoker 19 Diet risk score 19 Cardiac causes 7 Diabetes 5 Stress/depression 5 Alcohol intake 4
Are cholesterol levels responsiable for stroke risk facto?
Not really but ApopB to ApopA IS a relatively big risk factor
What% atheroscolotoc disease? Cardiac Embolism? Small vessel disease? Cryptogenic (unknown)? Haemorrhage?
Crytogenic - 30% Small vessle 25% Cardiac embolism and atherosclerotic cerebrovascular each 20% Haemorrhagic 10-15% Other 5%
What causes a haemorrhagic stroke?
A burst blood vessel
What is Amaloid?
When the blood vessel walls become glass like and so can fracture very easily
Which has worse outlook haemorrhage r ischemic?
Haemmhorage, more likely toresult in death or dependancy
What is a penumbra and when does it occur?
Its the area surrounding th earea of complete ischemia and infaction where the brain tissue gets enough oxygen to survive from other sources for a while but not obtaining enough to keep alive for long
How long in an Ischemic stroke does it take to llose 12km axonal fibres, 13.8 billion synapses and 1.9 million neurons?
1 minute!
What is an ischaemic stroke?
Caused by the occulsion of a vessel
hypoxia - ……….. - …………… - .oedema (swelling) causing further damage)
anoxia - infarction (necrosis)
How long does it take oedema to drecrease?
can be 10 days to a couple f weeks
What happens in the ischaemic cascade?
Hypoxia, anarobic metabolism - lactate released - eventually no more atp - atp pump fails - cell depolarises (NA CA in K out) - Ca triggers glutamate release - more ca into cells - proteases, lipases and free radiclals released due to over excitation
What is the excitotoxicity
Over excitement of the cell due to inappropriate Ca entry causonh extreme lipases, proteases and free radical release
What is released and can increase necrosis on death?
glutamate
Are Stroke symptoms fast onset?
Yes
Common carotid divide into what? How many common carotids do we have?
External and internal common carotids. Usually have 2 carotids (one each side)
How many vertebral arteries? Join to form what?
2 vertebral arteries, joining to form Basilar artery
What area of the brain : Produces speach Listening Comprehension of language speech como vision movement sensations swallowing, breathing, heartbeat, wakefulness, involuntary coordiation
Produces speach - Broca's area Listening - Temporal lobe Comprehension of language - Parietal lobe speech comprehension - Wenicke's area vision - occipital movement - motor cortex sensations - Sensory cortex swallowing, breathing, heartbeat, wakefulness, involuntary - brainstem coordiation - cerebellum
Where does ant cerebral artery supply? Post?
Anterior is more the front (shock horror) and posterior is more the back (wow!)
SIgns and symptoms of stroke?
Motor (clumsy or weak limb) Sensory (loss of feeling) Speech: Dysarthria/Dysphasia Neglect / visuospatial problems Vision: loss in one eye, or hemianopia Gaze palsy
Ataxia/ vertigo / incoordination / nystagmus
