Notes in 07_Stroke

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Published	02/10/2024	Blood Supply to the Brain[1] {{c1::Carotid system (supplies most of the hemispheres and cortical deep white matter)}}[2] {{c1::Vertebro-basi…
Published	02/10/2024	{{c1::Stroke}} is {{c2::the sudden onset of focal or global neurological symptoms caused by ischemia or hemorrhage and lasting more than 24 hours}}
Published	02/10/2024	Strokes are subdivided into {{c1::ischaemic (vessel occlusion or stenosis)}} and {{c1::haemorrhagic (vessel rupture)}}
Published	02/10/2024	{{c1::Transient Ischaemic Attack (TIA)}} is {{c2::neurological deficit caused by cerebral hypoperfusion characterized by the resolution of neurologica…
Published	02/10/2024	Which arteries are involved in a total anterior circulation stroke (TACS)?{{c1::The anterior AND middle cerebral arteries}}
Published	02/10/2024	Presentation of {{c2::Total Anterior Circulation Stroke (TACS)}}{{c1::All}} of the following: {{c1::Contralateral weakness or paralysis}} {{c1::Contra…
Published	02/10/2024	Which arteries are involved in a partial anterior circulation stroke (PACS)?{{c1::The anterior OR middle cerebral artery}}
Published	02/10/2024	Presentation of {{c2::Partial Anterior Circulation Stroke (PACS)}}{{c1::Two}} of the following:{{c1::Contralateral weakness or paralysis of the face, …
Published	02/10/2024	Which arteries are involved in a partial anterior circulation stroke (PACS)?{{c1::The vertebrobasilar arteries and associated branches (supp…
Published	02/10/2024	Presentation of {{c2::Posterior Circulation Stroke (POCS)}}{{c1::One}} of the following: {{c1::Bilateral motor/sensory deficit}} {{c1::Ipsilateral cra…
Published	02/10/2024	Which arteries are involved in a lacunar stroke (LACS)?{{c1::Small deep perforating arteries, typically supplying internal capsule or thalamus}}
Published	02/10/2024	Presentation of {{c2::Lacunar Stroke (LACS)}}{{c1::One }}of the following: {{c1::Pure sensory deficit}} {{c1::Pure motor deficit}}{{c1::Sensorimo…
Published	02/10/2024	Risk Factors of StrokeRemembered as {{c1::ASCOD}} {{c1::Atherosclerosis (usually internal carotid artery) Couch Potato (Metabolic Syndrome) Cholestero…
Published	02/10/2024	Stroke MimicsRemembered as the {{c1::7 S’s}} {{c1::Seizures}} {{c1::Syncope (hypotension)}} {{c1::Sugar (hypo/hyper)}} {{c1::Sepsis (+previous stroke…
Published	02/10/2024	Small end arteries coming directly off large arteries experience higher pressure and are at risk of {{c1::Lipohyalinosis}}
Published	02/10/2024	Routine Investigations of Stroke {{c1::CT or MRI head scan (ischaemic or haemorrhagic stroke)}} {{c1::ECG (50% of strokes are caused by atrial fibrill…
Published	02/10/2024	The system used to classify Stroke is the {{c1::Oxfordshire Community Stroke Project (OSCP) Stroke Classification}}
Published	02/10/2024	Score used for Establishing and Quantifying Neurological Deficiency is the {{c1::National Institutes of Health Stroke Scale (NIHSS)}}
Published	02/10/2024	Tool for Identifying a Stroke in the CommunityRemembered as {{c1::FAST}} {{c1::F – Face}} {{c1::A – Arm}} {{c1::S – Spee…
Published	02/10/2024	Approach to Ischaemic Stroke {{c1::Reperfusion, restore blood supply and prevent extension of ischaemic damage}} {{c1::Rule out intracranial haemorrha…
Published	02/10/2024	Prevention of Ischaemic Stroke {{c1::Continue Aspirin 300 mg for 2 weeks, then lifelong Clopidogrel 75 mg}} {{c1::If patient has Atrial fibrillation, …
Published	02/10/2024	In the context of prevention of Secondary Ischaemic Stroke, if patient has {{c1::Atrial fibrillation}}, start {{c2::anticoagulation (e.g. DOACs or War…
Published	02/10/2024	In the context of prevention of Secondary Ischaemic Stroke, consider {{c1::Carotid endarterectomy}} if there is {{c2::>50%}} carotid stenosis …
Published	02/10/2024	Step-wise Approach of Ischaemic Stroke Management {{c1::Admit patients to a Stroke Unit}} {{c1::Blood sugar (Exclude hypoglycaemia)}} {{c1::Immediate …
Published	02/10/2024	Indications for usage of Thrombolysis with alteplase {{c1::< 4.5 hours from symptom onset (uncertain if waking stroke)}} {{c1::Haemorrhage ruled ou…
Published	02/10/2024	Contraindication for usage of Thrombolysis with alteplase {{c1::On DOAC or therapeutic LMWH}} {{c1::Seizure at onset of symptoms}} {{c1::INR > 1.7}…
Published	02/10/2024	Indications for usage of Thrombectomy {{c1::Previously independent (Modified Rankin Scale, ‘’mRS’’ score ≥ 2)}} {{c1::Large vessel occlusion}} {{c1::N…
Published	02/10/2024	Treatment of Choice for Ischaemic Stroke with Large Vessel Occlusion{{c1::Thrombectomy <6 hrs up to 24 hrs}}
Published	02/10/2024	Approach to Haemorrhagic Stroke{{c1::Early Assessment and Management: (CT scan, NIHSS score, Reverse anticoagulation, BP control, DVT prophylaxis e.g.…
Published	02/10/2024	Prevention of Haemorrhagic Stroke {{c1::CT angiogram/MRI (underlying tumour or vascular problem)}} {{c1::BP control (<140/90}}
Published	02/10/2024	Step-wise Approach of Haemorrhagic Stroke Management {{c1::Admit patients to a specialist stroke unit}} {{c1::Immediate CT scan (confirms primary intr…
Published	02/10/2024	Patient that undergo Transient Ischaemic Attacks (TIAs) are at a higher risk of Stroke with a percentage of {{c1::10%}}
Published	02/10/2024	Management of Transient Ischaemic Attacks (TIAs) {{c1::Referral to TIA clinic within 24 hrs}} Secondary Preventative Medications: {{c1::Dual Antipla…
Published	02/10/2024	Patients must not drive for {{c1::1 month}} following a Transient Ischaemic Attack (TIA) and must prove that they are safe to drive
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