Sudden neurological deficit

The aim of this topic is to gain insight into the common causes of cerebrovascular disease or "strokes", with particular emphasis on haemorrhagic, thromboembolic and ischaemic diseases that affect the central nervous system.

Learning objectives:

At the completion of this topic you should be able to:

1. Summarise the frequency, morbidity and mortality associated with cerebrovascular disease in the community.
2. Describe the anatomy of the cerebral circulation, particularly the blood supply to the major functional regions of the cerebral cortex, cerebellum and brain stem.
3. Outline the major sensory and motor descending pathways from the cortex to the spinal cord.
4. Compare and contrast the three common stroke syndromes: haemorrhagic, thrombotic and embolic. In particular, outline the common syndromes that result from haemorrhage or infarction in particular anatomical sites.
5. Summarise the factors that predispose to cerebrovascular disease.
6. Outline the major stroke syndromes that result from occlusion of the anterior, middle and posterior cerebral arteries, as well as the effects of occlusion of the vertebral artery and the perforating branches of the lenticulo-striate arteries.
7. Outline the common sequelae that result from cerebral infarction.
8. Summarise the effects of raised intracranial pressure.
9. Describe the various types of intracranial haemorrhage, their common sites and factors predisposing to their development.
10. Describe the microscopic changes that occur in the brain as a result of ischaemia, and how these changes differ from those found in other organs undergoing ischaemic necrosis.

1. Outline the clinicopathological consequences of thrombotic occlusion of the left middle cerebral artery.
2. Write brief notes on intracranial haemorrhage.

Other relevant protocols - 46, 47

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