what is stroke?
- It is the destruction of a portion of the brain that is is a results of lack of circulation in speicifc vessels
What are the two types of strokes?
- Ischeamic
- Herrmoharge
What are the two types of ischeamic stroke?
- Thrombotic
- Embolic
what are the differences between thrombotic and embolic ischeamic stroke?
Thrombotic:
- Caused by platelet aggregation
- Onset is slow can occur during sleep
- Risk factors include large vessles e.g atherosclerosis
Embolic:
- Cuased by fragments formed outside the brain break and travel to vesles inside the brain
- Onset is abrupt and can occur during execise
- Risk factors include Afib or valve disease
What are the three types of hemorrhagic stroke?
- Subarachnoid hemorrhage - bursting of aneurysm (less common)
- Intracerebral hemorrhage - caused due to hypertension
- Intraventricular hemorrhage - an extension of ICH
Bleeding around the brain is subarachnoid hemorrhage. TRUE OR FALSE?
TRUE
Bleeding inside brain is Intracerebral, intraventricular. TRUE OR FALSE?
TRUE
What are some symptoms of stroke?
- Ataxia
- Aphasia
- facial drop
- N&V
- Dizziness
- Confusion
What are the steps for acute managment of stroke?
- Diagnosis of stroke
- Define stroke type
- Acute general medicines
- Re-perfusion
- Neuroprotection
Ischeamic region on a CT scan appears black due to oedema that has occured. true or flase?
true
Describe the pathology of ischemia?
- Ischemia leads to energy deficit
- Na+k+ channels fail to work
- leads to oedema
- Leads to narrowing of extracellular matrix
- Leads to restricted diffusion of water within the cell
In the absence of blood flow, available energy can maitian neuronal viability for 2-3 minutes. TRUE OR FLASE/
TRUE
The penumbra is potentilly salvageabke with early recannalization. TRUE OR FALSE?
TRUE
The penumbra is salvageable due to the fact that it is hypoperfused due to collateral blood flow. TRUE OR FLASE?
TRUE
What does rt-PA stand for?
- Recombinant thrombolysis plasminogen activator
What si the Mr of rt-PA?
- 68,000 daltons
rt-PA preferentially activates plasminogen bound to fibrin. TRUE OR FALSE?
TRUE
What is the mechanism of action of rt-PA?
- Converts plasminogen into plasmin which lyses fibrin clots
What is alteplase indicated for?
- Ischemic stroke
what are the side effects for alteplase?
- Bleeding
Thrombolytic drugs can be used to treat ischemic stroke. true or false?
true
what is the issue with thrombolytic drugs and older clots?
- older clots are more difficult to treat as they have more fibrin cross-linkages which reduces the efficacies of these drugs
What are the causes of hemorrhagic transformation?
- Damaged blood vessels
- Injured blood vessels become leaky
- Restored blood flow leads to hermorrhage
What are the symptoms of hermorrhagic transformation?
- increased BP
- Neurological damage is worsened
- Respiratory changes
