Stroke notes-Medicine., Study notes of Medicine

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about:blank + Strol Stroke - I/II Stroke Introduction characterised by acute neurological deficits lasting ‘a syndrome of vascular ori longer than 24 hours. - Transient ischaemic attack (TIA) is a transient (less than 24 hours) neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without evidence of acute infarction © TlAhasa sudden onset and can last from a few minutes to 24 hours. Most people have complete resolution of symptoms and signs within 1 hour Classification - Ischaemic stroke is an episode of neurological dysfunction caused by focal cerebral, spinal, or retinal cell death due to infarction following vascular occlusion or stenosis. = Haemorrhagic stroke is rapidly developing neurological dysfunction due to a focal collection of blood from within the brain parenchyma or ventricular system (intracerebral haemorrhage), or bleeding into the arachnoid space (subarachnoid haemorrhage) that is not caused by trauma. - Silent stroke is radiological or pathological evidence of an infarction or haemorrhage not caused by trauma without an attributable history of acute neurological dysfunction attributable to the lesion. Causes = 85% of strokes are ischaemic: ‘© Ischaemic strokes occur when large arteries (such as the extracranial carotid or vertebral arteries), intracranial arteries, or small penetrating arteries (lacunar) are occluded by: = Thrombus (complication of atherosclerosis) OR = Embolus of fatty material from an atherosclerotic plaque OR a clot in a larger artery / heart (e.g. in atrial fibrillation or atherosclerosis of the carotid arteries). © Other causes include: = Intracranial or extracrani thrombosis) = Or haematological conditions (e.g. sickle cell anaemia, antiphospholipid syndrome) or other hypercoagulable states. - Strokes may also occur where there is no identifiable cause. + 15% of strokes are haemorrhagic: © Intracerebral haemorrhage (10%) generally occurs in the absence of vascular malformations and are thought to be due to diseases affecting small cerebral vessels. The commonest cause is high blood pressure. vessels disease (e.g. dissection, vasculitis, venous 119