Podcast
Questions and Answers
Which type of stroke accounts for the majority of cases?
Which type of stroke accounts for the majority of cases?
What factor does NOT influence the consequences of a stroke?
What factor does NOT influence the consequences of a stroke?
Which risk factor is associated with an increased likelihood of ischaemic stroke?
Which risk factor is associated with an increased likelihood of ischaemic stroke?
What is the most common subtype of ischaemic stroke?
What is the most common subtype of ischaemic stroke?
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Which of the following is NOT a typical manifestation of hypoxia?
Which of the following is NOT a typical manifestation of hypoxia?
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What condition is most closely associated with the formation of athero-thrombi?
What condition is most closely associated with the formation of athero-thrombi?
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What is considered the major risk factor for parenchymal haemorrhage?
What is considered the major risk factor for parenchymal haemorrhage?
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What is the pathogenesis of lobar haemorrhage associated with cerebral amyloid angiopathy?
What is the pathogenesis of lobar haemorrhage associated with cerebral amyloid angiopathy?
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What should ideally be administered for the best outcomes after a stroke?
What should ideally be administered for the best outcomes after a stroke?
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Which anatomical factor does NOT influence stroke consequences?
Which anatomical factor does NOT influence stroke consequences?
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Which of the following does NOT indicate a condition in which thrombolysis would be contraindicated?
Which of the following does NOT indicate a condition in which thrombolysis would be contraindicated?
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What type of haemorrhage is most commonly associated with normotensive stroke in the elderly?
What type of haemorrhage is most commonly associated with normotensive stroke in the elderly?
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What condition is linked to arteriolar sclerosis leading to small vessel and slit haemorrhages?
What condition is linked to arteriolar sclerosis leading to small vessel and slit haemorrhages?
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What is the third most common cause of death in Australia?
What is the third most common cause of death in Australia?
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What percentage of stroke survivors experience some form of disability?
What percentage of stroke survivors experience some form of disability?
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How many new and recurrent strokes were reported in Australia in 2011?
How many new and recurrent strokes were reported in Australia in 2011?
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Which of the following statements about stroke mortality is true?
Which of the following statements about stroke mortality is true?
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What is the estimated annual cost of strokes to Australia?
What is the estimated annual cost of strokes to Australia?
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What is one key feature of cerebral ischaemia?
What is one key feature of cerebral ischaemia?
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Which type of stroke includes haemorrhagic stroke?
Which type of stroke includes haemorrhagic stroke?
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What is a common outcome for individuals after experiencing their first stroke?
What is a common outcome for individuals after experiencing their first stroke?
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What occurs in the ischemic penumbra if blood flow is restored?
What occurs in the ischemic penumbra if blood flow is restored?
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Which of the following is NOT a molecular event associated with acute ischemia?
Which of the following is NOT a molecular event associated with acute ischemia?
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What type of infarct is associated with occlusion of small penetrating arteries?
What type of infarct is associated with occlusion of small penetrating arteries?
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Which of the following best describes the characteristics of an acute brain infarct?
Which of the following best describes the characteristics of an acute brain infarct?
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What is one consequence of ischemia-reperfusion injury following thrombolytic treatment?
What is one consequence of ischemia-reperfusion injury following thrombolytic treatment?
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How do reactive astrocytes respond to a brain infarct in the subacute phase?
How do reactive astrocytes respond to a brain infarct in the subacute phase?
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What is a key feature of brain infarcts during the remote phase?
What is a key feature of brain infarcts during the remote phase?
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Which type of stroke is characterized primarily by the blockage of blood vessels?
Which type of stroke is characterized primarily by the blockage of blood vessels?
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Which type of stroke is associated with large artery athero-thrombosis?
Which type of stroke is associated with large artery athero-thrombosis?
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What is a common cause of embolic strokes?
What is a common cause of embolic strokes?
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Which artery territory is most commonly affected by embolic strokes?
Which artery territory is most commonly affected by embolic strokes?
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What characterizes transient ischemic attacks (TIA)?
What characterizes transient ischemic attacks (TIA)?
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Which factor is NOT a source of emboli?
Which factor is NOT a source of emboli?
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What type of occlusion is associated with small penetrating arteries?
What type of occlusion is associated with small penetrating arteries?
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Which of these is a characteristic of thrombo-emboli?
Which of these is a characteristic of thrombo-emboli?
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What role does atrial fibrillation play in ischemic strokes?
What role does atrial fibrillation play in ischemic strokes?
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Study Notes
Stroke Overview
- Stroke is Australia's third leading cause of death and a major disability cause.
- Approximately 60,000 new and recurrent strokes occurred in Australia in 2011.
- Mortality rates: 1 in 5 first-ever stroke victims die within a month; 1 in 3 die within a year.
- Stroke prevalence: more fatalities in women than from breast cancer, and in men than from prostate cancer.
- Around 88% of stroke survivors experience some form of disability.
- Economic impact: approximately 6billionannuallyindirectcosts,plus6 billion annually in direct costs, plus 6billionannuallyindirectcosts,plus26 billion due to premature mortality and disability.
Ischaemia vs Hypoxia
- Ischaemia results from a decrease in blood supply, always pathogenic and leads to nutrient deficiency and waste buildup.
- Hypoxia, a decrease in oxygen supply or utilization, can be non-pathogenic if blood flow increases.
Types of Stroke
- Ischaemic strokes account for 88% and include:
- Large artery athero-thrombosis (most prevalent)
- Embolism
- Haemorrhagic strokes represent 12%.
- There are cases categorized as "unknown."
Consequences of Stroke
- Effects vary based on stroke type, affected vessel size, anatomical location, time elapsed since occurrence, and treatment (e.g., thrombolysis within 4 hours).
Risk Factors for Ischaemic Stroke
- Key risk factors include:
- Age
- Hypertension
- Obesity and diabetes
- Hyperlipidemia
- Family history of stroke
- Heart disease, especially atrial fibrillation
- Cigarette smoking
- Previous stroke
- Ethnicity
Stroke Subtypes
- Ischaemic strokes subtypes:
- Large artery athero-thrombosis
- Small (penetrating) artery occlusion
- Embolism
- Haemorrhagic strokes include parenchymal and lobar haemorrhages.
Pathogenesis of Athero-thrombus
- Initiated by hyperlipidaemia and endothelial damage leading to fatty streaks and atherosclerotic plaques, eventually causing vessel occlusion.
Ischaemic Penumbra
- Area surrounding a stroke's core where retaining blood flow can preserve neuron viability.
Acute Ischemia Molecular Events
- Glutamate release increases intracellular calcium, causing membrane and DNA damage.
- Decreased energy production due to failed ionic pumps and mitochondrial injury.
Morphological Changes in Brain Infarct
- Acute (≤ 2 days): Softening, swelling from edema, infiltration of neutrophils, and ischaemic neuronal changes.
- Subacute (days to weeks): Liquefaction leading to cavitation, presence of foamy macrophages, and reactive astrocytes forming glial scar.
- Remote (weeks onward): Presence of cavitation, glial scar, and haemosiderin-laden macrophages indicates past injury.
Lacunar Infarcts
- Caused by occlusion of small penetrating arteries, linked to hypertension, resulting in small infarcts in deep brain structures.
- Often asymptomatic or result in transient ischemic attacks (TIAs).
Sources of Emboli
- Thrombo-emboli can originate from:
- Arteries (e.g., carotid, aortic arch)
- Heart conditions like atrial fibrillation
- Other types include atheroma and systemic emboli from sources such as fat or air.
Major Causes of Haemorrhagic Stroke
- Hypertension is the primary risk factor leading to arteriolar sclerosis.
- Can result in parenchymal and lobar hemorrhages, with lobar hemorrhage often associated with cerebral amyloid angiopathy, prevalent in Alzheimer's disease patients.
Diagnosis and Management
- CT scans are essential for identifying hemorrhage; if present, thrombolysis should be avoided to prevent complications.
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Description
Test your knowledge of neurological concepts covered in CPAT 3202. This quiz focuses on key topics related to neuroanatomy and neurophysiology, providing a comprehensive review for students in the course. Challenge yourself and enhance your understanding of neuroscience essentials.
