Flashcards in Week 202 - Stroke: Deck (16)
Week 202 - Stroke: What are the basic set of investigations that should be applied to all individuals?
FBC, BP, ECG, CXR, Cerebral imaging (CT/MRI)
Week 202 - Stroke: What are the two basic principles of treatment for stroke?
• To reduce/reverse the impact of the damage (E.g Thrombolysis/rehabilitation)
• Reduce the risk of recurrence.
Week 202 - Stroke: What is thrombolysis and on who should it be performed?
• I.V. recombinant tissue plasminogen activator (rTPA)
• Patient selection is VITAL, <3hrs and no risk factors for developing intracerebral haemorrhage.
Week 202 - Stroke: Give a basic definition of stroke.
A neurological deficit related to an atraumatic vascular event.
Week 202 - Stroke: What are the two broad categories of stroke and what % does each make up of cases?
• Ischaemic - 85%
• Ischaemic - 15%
Week 202 - Stroke: What are the major vessels that make up the anterior part of the intracerebral circulation?
• Internal carotids
• Anterior cerebral artery
• Middle cerebral arteries
+ Anterior and posterior communicating arteries.
Week 202 - Stroke: What are the major vessels that make up the posterior part of the intracerebral circulation?
• Vertebral arteries
• Basilar artery
• Posterior cerebral artery
Week 202 - Stroke: Describe the part of the brain that is supplied by the Anterior cerebral artery.
• The medial part of the hemispheres ( A strip that runs along the middle of the brain).
Week 202 - Stroke: Describe the part of the brain that is supplied by the middle cerebral artery.
• The lateral part of the hemispheres, i.e. the temporal and parietal parts.
Week 202 - Stroke: Describe which part of the brain is supplied by the posterior cerebral artery.
• The occipital part.
Week 202 - Stroke: A Typical stroke, Infarction of the left cerebral artery affecting the left cerebral hemisphere motor and language areas. What would the clinical picture be?
• Acute Right hemiparesis and dysphasia. (FAST)
• No loss of consciousness.
Week 202 - Stroke: What is the typical clinical picture of a primary intracranial haemorrhage (PICH)? And what is a typical triggering factor for this type of stroke?
• Very acute, hemi-anaesthesia, +/- loss of consciousness, +/- raised intracranial pressure.
• Typically a hypertensive patient / anti-coagulated.
Week 202 - Stroke: What is the typically presentation of a sub-arachnoid haemorrhage?
• Sudden hemi-anaesthesia, meningism and loss of consciousness.
Week 202 - Stroke: How is the demographic for Cerebral venous sinus thrombosis different from that of other strokes?
• It occurs at a younger age.
Week 202 - Stroke: If you were to have a brainstem or spinal stroke, what would the clinical presentation be?
• Ataxia, Diplopia, Dysarthria, Lower cranial nerves, hemiparesis.