16 Stroke

Question 1

what are the 4 types of stroke

Answer 1

• ischemic stroke
• hemorrhagic stroke
• subarachnoid haemorrhage
• venous sinus thrombosis

Question 2

what is the most common type of stroke

Answer 2

ischemic

Question 3

what is a hemorrhagic stroke (ICH)

Answer 3

vascular disruption followed by intracranial haemorrhage (bleed out)

Question 4

when does ICH occur

Answer 4

with disruption of the blood vessels, usually small capillaries

Question 5

causes of ICH

Answer 5

most common is malignant hypertension
OR
tumour, AVM, cerebral amyloid antipathy and sympathomimetic drugs

Question 6

do you tend to have good outcomes from ICH

Answer 6

no

Question 7

treatment of ICH

Answer 7

surgery
haemostatic therapy
anticoagulant reversals

Question 8

pathogenesis of large artery atherosclerosis and ischemia

Answer 8

• endothelial injury
• migration of macrophages to site of injury
• formation of fatty streak
• deposition of foam cells
• inflammation
• stenosis
• ulceration of plaque

Question 9

what Is the ischemic penumbra

Answer 9

the salvageable part of brain

Question 10

characteristics of ischemic penumbra

Answer 10

• acute hypoxia/anoxia
• inflammation
• necrosis

Question 11

surgical management of stroke

Answer 11

• thrombolysis
• surgical thromboectomy
• CT scan/ MRI to ensure no bleeding

Question 12

what does successful outcome of stroke treatment depend on

Answer 12

time

4-6hrs commence ideally

Question 13

what is alteplase

Answer 13

a recombinant tissue plasminogen activator that’s used as a thrombolytic agent

Question 14

what is a thromboectomy

Answer 14

a surgery to remove a blood clot from the blood vessel

Question 15

aspirin dose after thrombotic stroke

Answer 15

aspirin daily 300mg until 2 weeks after the onset of stroke symptoms

then start long term anitplatelets

Question 16

should you use anticoagulants for treatment of stroke

Answer 16

not routinely