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Stroke

Types of stroke

Broadly, a stroke can be divided into ischaemic stroke or intracerebral haemorrhage. Types of ischaemic stroke include:

  • Total anterior circulation stoke (TACS) 3/3 of – Higher function (speech/apraxia/neglect), Hemianopia, Hemi-loss (motor/sensory)
  • Partial anterior circulation stroke (PACS) 2/3  of – Higher function (speech/apraxia/neglect), Hemianopia, Hemi-loss (motor/sensory)
  • Lacunar stroke (LACS) 1/3 of – Higher function (speech/apraxia/neglect), Hemianopia, Hemi-loss (motor/sensory)
  • Posterior circulation stroke (POCS) – vertebrobasilar arterial system occlusions
    • Occipital → isolated contralateral homonymous visual field defect
    • Cerebellar ipsilateral cerebellar signs
    • Brainstem → ipsilateral cranial nerve palsies, bilateral sensory/motor deficit, disorder of eye movements 

Possible clinical features by vascular territory

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Circle of Willis

Investigations and management

See stroke acute management notes

Questions for you

Please list three risk factors for ischaemic stroke

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Please list three risk factors for haemorrhagic stroke

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Which type of stroke do carotid and vertebral artery dissections cause? When should you suspect dissection as a cause?

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What is pyramidal weakness?

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Try some OSCE stations

  1. Transient ischemic attack
  2. Stroke
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