Conditions: Cardiovascular > Stroke > Flashcards

Stroke Flashcards

(62 cards)

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1
Q

What is the definition of stroke?

A
  • Neurological deficit of sudden onset lasting for more than 24 hours
  • Vascular origin
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2
Q

What does TIA stand for?

A
  • Transient ischaemic attack
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3
Q

What is a TIA?

A
  • A stroke resulting in a neurological deficit of less than 24 hours
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4
Q

What are the 4 subtypes of stroke?

A
  • TACS
  • PACS
  • LACS
  • POCS
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5
Q

What does TACS stand for?

A
  • Total anterior circulation stroke
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6
Q

What percentage of strokes are TACS?

A
  • 20%
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7
Q

What is the mortality of TACS?

A
  • The worst of the 4
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8
Q

What does PACS stand for?

A
  • Partial anterior circulation stroke
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9
Q

What percentage of strokes are PACS?

A
  • 35%
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10
Q

What does LACS stand for?

A
  • Lacunar stroke
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11
Q

What percentage of strokes are LACS?

A
  • 20%
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12
Q

What does POCS stand for?

A
  • Posterior circulation stroke
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13
Q

What percentage of strokes are POCS?

A
  • 25%
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14
Q

What is special about POCS?

A
  • Highest recurrence rate
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15
Q

What do the symptoms of stroke depend on?

A
  • The area of the brain affected
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16
Q

What are the 5 things that can be lost due to a stroke?

A
  • Power
  • Sensation
  • Speech
  • Vision
  • Coordination
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17
Q

How can power be lost?

A
  • Loss of motor control
  • Clumsiness
  • Weak limb
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18
Q

How can sensation be lost?

A
  • Loss of feeling in areas of the body
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19
Q

What 2 ways can throat function be affected?

A
  • Dysarthria (slurred speech)

- Dysphagia

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20
Q

What ways can visual function be affected?

A
  • Visuospatial problems
  • One eye affected
  • Hemianopia
  • Gaze palsy
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21
Q

What is hemianopia?

A
  • Blindness over half the field of vision
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22
Q

What is gaze palsy?

A
  • Inability to move the eyes in the same direction of motion
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23
Q

What 4 conditions can coordination be affected due to?

A
  • Ataxia
  • Vertigo
  • Incoordination
  • Nystagmus
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24
Q

What is ataxia?

A
  • Loss of voluntary function
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25
What is nystagmus?
Constant uncontrolled eye movements
26
What modifiable risk factors are there for stroke?
- Hypertension | - AF (loss of adequate blood flow to the brain)
27
What are the non modifiable risk factors for strokes?
- Age - Race - Family history
28
What is the cause of stroke?
- Damage to part of the brain due to blockage of a blood vessel by thrombus or embolism OR - Haemorrhage from a ruptured blood vessel
29
What percentage of strokes are caused by infarction?
- 85%
30
What are the 5 ways that infarction can occur in vessels in the brain?
- Large artery atherosclerosis - Cardioembolic stroke - Small artery occlusion - Undetermind/cryptogenic - Rare causes
31
What percentage of infarcting strokes are caused by large artery atherosclerosis?
- 35%
32
What large artery is usually the one to cause an infarction due to it having atheromatous plaques and what do these plaques do to the artery?
- Carotid artery | - Cause carotid stenosis which will be heard as a bruit on examination
33
What is a cardioembolic stroke a result of?
- AF
34
What percentage of infarcting strokes are cardioembolic strokes?
- 25%
35
What type of stroke is a result from small artery occlusion?
Lacunar
36
What percentage of infarcting strokes are from small artery occlusion?
- 25%
37
What percentage of infarcting strokes are from undetermined/cryptogenic causes?
- 10 - 15%
38
What rare causes may result in a stroke?
- Aortic dissection | - Venous sinus thrombosis
39
What percentage of strokes are from haemorrhage?
- 15%
40
What is the main cause of haemorrhagic stroke?
- Primary intracerebral haemorrhage
41
What is a primary intracerebral haemorrhage?
- A bleed in the brain tissue
42
What pathologies can cause a primary intracerebral haemorrhage?
- Brain trauma - Aneurysm - Tumours
43
What type of haemorrhages account for the other 30% of haemorrhagic stroke?
- Subarachnoid | - Arteriovenous malformations
44
What initial tests should be carried out on presentation of a suspected stroke?
- Blood tests - ECG - CT scan - MRI - Carotid doppler - Echocardiogram
45
What blood tests should be carried out?
- FBC (platelets and RBC's) - Lipid count - ESR
46
What is the benefit of a CT scan?
- Quick | - Shows the area of the infarct
47
What are the benefits of an MRI?
- Better for ischaemic stroke diagnosis
48
What are the detriments of MRI?
- Takes longer | - Claustrophobic
49
Why is an echocardiogram used in stroke diagnosis?
- Look for clots in the heart
50
What unit should the patient be referred to after diagnosis?
- Stroke unit
51
What things should be done in the stroke unit?
- Mobility | - Concentrate on simple things for the patient such as swallowing and positioning
52
What treatment should be performed in the stroke unit?
- Anti coagulation
53
What initial treatment should be done to reduce effects of a stroke?
- THROMBOLYSIS | - Clot retrieval using minimally invasive surgery
54
What is the aim of thrombolysis?
- Restore perfusion before cell death occurs
55
What drugs are used in thrombolysis?
- Alteplase - Reteplase - Tenecteplase
56
What type of drug are all alteplase, reteplase and tenecteplase?
- Tissue plasminogen activators
57
What do tissue plasminogen activators do?
Convert plasminogen to plasmin to break down clot
58
At what time do risks of thrombolysis outweigh the benefits?
- Around 4.5 hours after event
59
How is minimally invasive clot retrieval surgery performed?
- Catherter with a retrieval device on the end
60
What is the typical history of presenting complaint of a stroke?
- Headache - Vomiting - Neck stiffness - Photophobia - Loss of consciousness - Fit - Incontinence
61
What does photophobia suggest?
- The stroke is haemorrhagic
62
What does post thrombolysis haemorrhage risk depend on?
- Infarct size - Vessel occlusion - Diabetes - BP - Age
Conditions: Cardiovascular
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