Neurology

In: Other Topics

Submitted By ben5325
Words 333
Pages 2
Blood supply of brain
Pair of Internal Carotid arteries
Pair of vertebral arteries form Circle of Willis

Classification(2 types)
TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria Based on causation

Oxfordshire Community Stroke Project(OCSP) Classification Based on clinical presentation
TOAST
Large artery atherosclerosis
Cardioembolism
Small vessel disease
Stroke of other determined aetiology
Stroke of undetermined aetiology

OCSP (Clinical classification)
TACS (Total Anterior Circulation Stroke)
PACS (Partial Anterior Circulation Stroke)
LACS (Lacunar Stroke)
POCS (Posterior Circulation Stroke)

Only a scan will determine if the stroke is due to an infarct or a haemorrhage

TACS and PACS- cortex involved- always have higher mental fns affected- usually embolic stroke(if ischaemic)
LACS- cortex NOT involved- usually due to small vessel disease(if ischaemic)
POCS- posterior circulation stroke- could be embolic or small vessel disease
Why is this important? TACS- worst prognosis, poorer rehab potential, longer hospital stay as opposed to LACS
History
Is it acute onset, time of onset of symptoms essential for thrombolysis, witness account if possible
Current symptoms (assess if focal or not)
Past medical history- Diabetes, HTN, Dyslipidaemic, Ischaemic heart disease, atrial fibrillation
Smoking, lifestyle, medications(esp warfarin), intolerances
Social history

Examination
Evidence of heart failure, AF, peripheral pulses
Higher mental fns involved?- suggests cortical involvement Dominant- some variant of dysphasia Non dominant- neglect, dyspraxia, spatial disorientation, emotional lability, inattention
Motor, sensory, hemianopia
Cerebellar or brainstem signs

Case 1
YD 60/F
Right face,arm and leg weakness and aphasia.
Time of onset…...

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