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One. Thank you very much for joining our session. Um So today we'll be going through the high yield uh, presentations for uh neurosurgical conditions and, um, this will hopefully be very useful for um, your upcoming exams and we try to map the content uh to the MRA as well. Um So we'll give it a couple more minutes before we start. We'll start at 505 past six. we'll send the feedback um, in the chat as well. So the pre session feedback form, um, if you could fill those in, in the meantime, that would be uh great and I will really appreciate, um, your help as well. Um So, and uh, yeah, last session we didn't, uh, have any questionnaire, unfortunately. So we'll count as everyone else attended the session. Um, so please don't worry about that. Bye. Hi, everyone. Um, so we'll start the uh, session. Now. Can everyone please confirm if, uh, you can all hear me? Yes. Ok. Um Yeah, so can anyone hear me? Ok, that's good. Um So yeah, um, hopefully you've all filled in the, uh, pre session feedback form. Um And, uh, so again, this is the um course timeline. This is uh the session on the higher neurosurgical presentation. Hopefully, um we'll be able to help you in exam preparation. Um And uh so the content for today is that we'll be going over stroke and tia um and also hemorrhages. So all of those content are mapped to the MLA um content list and those are kind of the main higher uh conditions that you'll see in exams. Um So, stroke is basically a neurological deficit that is caused by vascular compromise leading to a disruption in cerebral perfusion. So brain is uh supplied by a rich network of blood vessels. And um when there is a obstruction or hemorrhage, um it will cause a disruption of the blood vessel uh uh of the blood um kind of perfusing the brain. And that's basically what stroke is. Um I know it's a very complex um kind of condition uh because there are so many different types of stroke. So I tried to break it down um for you guys. So it's easier to understand. Um and we'll be going over each classification. So I've broke it down by pathophysiology, vascular territory and symptoms. They are not kind of isolated classifications. So for example, if you have a ischemic stroke, um it can also be ac A and which is anterior cerebral artery stroke and that can also be the partial anterior cerebral artery stroke. Um So all of those uh classifications overlap A bit um just to just a, as a note. So I'll be going over the uh pathophysiology classification first. Um So it can be classified into ischemic and hemorrhagic, which I'm sure most of you will know the ischemic one is the most common one. And uh um one thing to, to kind of remember is that af is a common cause of ischemic stroke and that's why uh you have the chance to vas score, um which is basically determining people with af and determining their risk of having stroke and giving anticoagulation if needed. Um for the hemorrhagic, it's only the uh intracerebral hemorrhage and sub arachnoid hemorrhage that counts as hemorrhagic stroke, uh extradural and subdural doesn't count, but Karen will be going over um the uh kind of different types of hemorrhages later as well. And um again, an important thing to note in the hemorrhagic stroke is basically hypertension is a common cause of uh stroke or kind of intracerebral bleed. And um that is uh of often a common cause of stroke for young people as well. So, if someone have uncontrolled hypertension, um it's really important to consider the risk of stroke. So that's quite a kind of a straightforward classification. The next one is uh by vascular territories. And uh this can be broken down into three big categories. So, anterior cerebral artery stroke, middle, cerebral artery stroke, and posterior art uh cerebral artery stroke. And um again, if you have uh any questions? Uh In the meantime, please uh put them in the chat. So those are kind of a few diagrams of uh where the different types of stroke can happen. Um So basically for the blood supply for the brain, you have the anterior uh ce artery here, this is the middle cerebral artery and then the posterior.