Stroke / TIA

What is a stroke?

When blood supply to part of the brain is cut off

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2 causes of stroke

Ischaemic - clot causes less blood to get through the artery
Haemorrhagic - burst artery leading to less blood flow to the brain

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What is a TIA

A temporary disruption in the blood supply to part of the brain
Fully resolve within 24 hours

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Symptoms of stroke

Unilateral facial palsy
One sided limb weakness
Dysphagia
FAST +ve

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Symptoms of posterior stroke

Dizziness
Dysarthria
Abnormal gait / balance problems
Headache
Nystagmus
Loss of peripheral vision

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FAST test

Face - smile wide with teeth
Arms - push me away, pull me towards, squeeze hands
Speech - say you can't teach an old dog new tricks

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Cranial nerves

CN1 - olfactory - smell
CN2 - optic - PERRLA
CN3, CN4, CN6 - oculomotor, trochlear, abducens - H and X
CN5 - trigeminal - facial sensations
CN7 - facial - puff out cheeks
CN8 - vestibulocochlear - click next to ears
CN9, CN10, CN12 - glossopharyngeal, ***

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Pharmacological intervention for TIA

Aspirin

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ASPIRIN

Antiplatelet, COX enzyme inhibitor
Dose: 300mg, 1 tablet

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Management of stroke / TIA

FAST +ve should be ATMIST to hospital
Patients with ongoing neurological deficit should be treated as an acute stroke
Request P1 backup if on an RRV
Suspected TIA must be referred for specialist assessment
TIA patient with risk factors should be conveyed

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Get Revising

Stroke / TIA

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Card 4

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Card 5

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