Stroke CC2

Question 1

most ischemic strokes are of ___ etiology

Answer 1

embolic (33%)

30% are large vessel

20% are small vessel

Question 2

___% of strokes are ischemic

Answer 2

83

Question 3

__% of strokes are intracerebral hemorrhage

Answer 3

10

Question 4

__% of strokes are subarchnoid hemorrhages

Answer 4

7

Question 5

1 risk factor for strokes is

Answer 5

high bp

Question 6

nonmodifiable risk factors for stroke

Answer 6

age, sex, family history

Question 7

stroke mimics include (5)

Answer 7

1. hypoglycemia
2. mass lesions
3. seizures/postictal states
4. migraine
5. psychogenic hemiparesis

Question 8

contralateral hemiparesis (weakness on one side of the body) suggests ___ stroke

Answer 8

MCA

Question 9

sx of anterior division MCA stroke

Answer 9

contralateral head & eye deviation

Question 10

sx of posterior division MCA stroke

Answer 10

hemianopsia (contralateral visual field deficit),

Question 11

is ____ is occluded on the right side, what sx do you get neglect

Answer 11

posterior division MCA

Question 12

leg and foot deficits seen with

Answer 12

ACA stroke

Question 13

what could cause cortical blindness

Answer 13

bilateral PCA stroke

Question 14

what is hemihypaesthesia? with what artery occlusion do you see it?

Answer 14

complete loss of sensation of the contralateral face, arm, trunk and leg

seen with PCA

Question 15

signs of basialr/brainstem stroke

Answer 15

altered consciousness & crossed signs:

cranial nerve deficit on one
side

hemiparesis or sensation loss of body on other side

Question 16

loss of perfusion to internal capsule by lenticulostriate causes __ sx

Answer 16

pure motor hemiplegia (whole
side)

Question 17

loss of perfusion to thalamus by lenticulostriate causes __ sx

Answer 17

pure sensory hypaesthesia (whole side)

Question 18

loss of perfusion to pons by lenticulostriate causes __ sx

Answer 18

dysarthria, clumsy hand syndrome

Question 19

what do you use to rule out hemorrhage?

Answer 19

ct scan (shows up white)

Question 20

early infarct signs on a ct

Answer 20

1. hypodensity of grey or white matter
2. obliteration of cortical sulci
3. obscured basal ganglia
4. loss of insular ribbon

Question 21

aphasia indicates ___

Answer 21

L. hemispheric stroke

Question 22

neglect / hemi-inattention indicates

Answer 22

R. hemispheric stroke

Question 23

patients usually look ___ the lesion

Answer 23

toward

Question 24

crossed signs –> ___ involvement

Answer 24

brainstem

Question 25

vertigo of central origin usu. means

Answer 25

other cranial nerve deficits

Question 26

vertical nystagmus is brainstem ____ until proven otherwise

Answer 26

ischemia

Question 27

tPA Indications and Contraindications Inculsion if: age\_\_\_

Answer 27

less than 80

Question 28

tPA Indications and Contraindications Inculsion if: onset is

Answer 28

less than 3 hours

Question 29

tPA Indications and Contraindications Inculsion if: NIHSS \_\_\_

Answer 29

less than 24

Question 30

tPA Indications and Contraindications Inculsion if: ___ consent

Answer 30

informed

Question 31

tPA Indications and Contraindications **EXCLUSION** if: (danger zone)

Answer 31

- CT signs of hemorrhage or very large infarction - undetermined time of onset - uncontrollable hypertension or blood sugar - recent trauma, major surgery or bleeding - abnormal coagulation profile - hemodynamic compromise from MI - rapidly resolving deficit

Question 32

tPA Risks and Benefits: treatment group had \_\_\_% more patients rated at “good outcome” after 3 months.

Answer 32

30

Question 33

risk of hemorrhage was \_\_% with tPA treatment (1% without)

Answer 33

6

Question 34

hemorrhage after tpa --\> \_\_% mortality rate

Answer 34

50

Question 35

secondary risk prevention includes control of modifiable risk factors like

Answer 35

HTN, diabetes, CAD, obesity

Question 36

\_\_\_ new or recurrent strokes each year.

Answer 36

600,000

Question 37

in terms of RR, which is the #1 risk factor of stroke

Answer 37

a. fib

Question 38

\_\_ stenosis is a risk factor of stroke

Answer 38

carotid

Question 39

most common area affected by hemiparesis with right MCA stroke?

Answer 39

face=hand \> arm \> leg

Question 40

lacunar syndromes involves

Answer 40

pure motor hemiplegia from damage to the internal cpasule

Question 41

???

Answer 41

subarahnoid hemorrhage

Question 42

Answer 42

subdural hematoma

Question 43

what is this??

Answer 43

hyperdense MCA sign early dx of stroke? an appearance of **increased attenuation** of the **_proximal middle cerebral artery (MCA)_** that is often associated with thrombosis of the M1 MCA segment