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

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
  3. Find more here

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