Editing Stroke (section)

== '''Ischaemic stroke''' ==

=== Risk factors: ===

* Male sex
* Age - for each decade >55, risk of stroke doubles
* Race - black
* HTN
* FHx
* AF
* Smoking
* Hchol
* Physical activity
* Diabetes
* Obesity
* Diet
* Alcohol heavy
* Renal insufficiency

=== Outcome of stroke ===

* Recurrence:
** 2% at 7 days
** 4% at 30 days
** 12% at one year
** 29% at five years
* Recurrence in setting of symptomatic carotid disease:
** 26% over two years

=== Craniotomes: ===

* Carotid (anterior circulation): 
** '''Contralateral sensorimotor loss'''
*** Can range from mild hemiparesis to complete hemiparesis
*** Sensory deficits can be mild numbness or complete paraesthesia
** '''Speech deficit'''
*** Dysarthria - deficiency in muscles for speech
*** Dysphasia - deficiency in generation of speech
*** Aphasia
** '''Ipsilateral monocular blindness'''
*** Amaurosis fugax (emboli to retinal artery via ophthalmic artery) is the classic sign of TIA related to carotid lesions
* Posterior circulation (vertebral arteries):
** Dizziness
** Difficulty focusing visually
** Loss of balance
* Cerebellum:
** Vertigo
** Vomiting
** Blurred vision
** Difficulty walking
* Lacunar infarcts can present as one of the following:
** Pure motor hemiparesis
** Pure sensory syndrome
** Sensorimotor syndrome
** Ataxic hemiparesis
** Dysarthria-clumsy hand syndrome

=== Prevention: ===

* Statins for:
** LDL >4.1
** Males >45 and females >55 with following risk factors:
*** Positive family history
*** Smoking
*** HTN
*** LVH

=== Treatment of acute stroke ===

* Most often supportive and medical

[[Category:Neurology]]