Stroke I Flashcards

1
Q

are strokes defined at all by the element of time?

A

no

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2
Q

what is a TIA?

A

transient ischemic stroke - stroke process without cell death

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3
Q

what are the two major subtypes of stroke? what are the proportions?

A
  • hemorrhagic (15%)

- ischemic (85%)

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4
Q

what is the most common cause / subtype of ischemic stroke?

A

cryptogenic

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5
Q

what are the symptoms of lacunar strokes?

A
  • pure motor
  • pure sensory
  • mixed
  • clumsy hand (less common)
  • dysarthria
  • ataxic hemiparesis (beyond weakness, very clumsy / ataxic)
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6
Q

what are the major risk factors for lacunar strokes?

A
  • HTN
  • age
  • diabetes
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7
Q

the lenticulostriate arteries supply what major brain areas?

A
  • head of caudate
  • internal capsule
  • thalamus
  • lentiform nucleus (globus pallidus medially, putamen laterally)
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8
Q

what are the two types of onset / progression for lacunar strokes?

A
  • very sudden (more common)

- stuttering

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9
Q

most of the time strokes are NOT ____________

A

stereotypical

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10
Q

lacunar strokes display what type of specific pathology? what are the major risk factors for this?

A
  • lipohyalinosis
  • HTN
  • age
  • diabetes
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11
Q

what is the number 1 determinant / risk factor for stroke?

A

age

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12
Q

lacunar strokes are prone to what type of aneurysms?

A

charcot-bouchard type

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13
Q

what is dejerine-roussy?

A

pain syndrome caused by a stroke to the thalamus

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14
Q

what are the symptoms of stroke? what is the overarching theme?

A
  • sudden hemiparesis or hemisensory loss
  • sudden confusion, aphasia, dyarthria
  • sudden visual loss
  • sudden severe headache without apparent cause
  • sudden ataxia, dizziness, or incoordination
  • sudden change in neurologic function
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15
Q

strokes in the anterior circle of willis lead to what symptoms?

A
  • motor
  • sensory
  • speech
  • language**
  • vision
  • cognition
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16
Q

strokes in the posterior circle of willis lead to what symptoms?

A
  • motor
  • sensory
  • speech
  • vision
  • CNs**
  • cognition
17
Q

the anterior circle of willis pertains to what arteries?

A

carotid and branches

18
Q

the posterior circle of willis pertains to what arteries?

A

vertebrobasilar and its branches

19
Q

what are the two types of hemorrhagic stroke and their prevalences?

A
  • intraparenchymal 10%

- subarachnoid 5%

20
Q

where do intraparenchymal hemorrhages typically occur? what is the usual cause?

A
  • basal ganglia
  • internal capsule
  • pons
  • thalamus
  • deep cerebellum
  • HYPERTENSION
21
Q

which test is 99.9% sensitive for acute blood?

A

HCT (head CT)

22
Q

what is the main cause of subarachnoid hemorrhage?

A

rupture of intracranial saccular aneurysms 80%

23
Q

what is a sentinel hemorrhage?

A

tiny bleeds that can occur before a large stroke occurs

24
Q

what is the clinical presentation for subaarachnoid hemorrhage?

A
  • sudden severe headache
  • LOC, focal neuro findings variable
  • meningeal signs variable
  • subhyaloid hemorrhages within eye variable
  • sentinel hemorrhage 10-50% may precede
25
Q

what test is done to assess for subarachnoid hemorrhage?

A

CT - 95% sensitive

26
Q

in subarachnoid hemorrhages, what test is 100% positive by 12 hours, and lasts up to 2 weeks?

A

xanthochromia of CSF (yellowish discoloration due to blood)

27
Q

what is the treatment for subarachnoid hemorrhage?

A
  • ICU
  • bed rest and quiet
  • BP management
  • nimodipine 21 days
  • neurosurgical or intravascular intervention with clips or coils when possible
28
Q

what medication is given for subarachnoid hemorrhage treatment?

A

nimodipine

29
Q

what is a major complication of subarachnoid hemorrhage? when is risk greatest? what is given to prevent it?

A
  • vasospasm
  • 4-21 days
  • nimodipine, triple H therapy (HTN, hemodilution, hypervolemia)
30
Q

what are the results of hyponatremia as a subarachnoid hemorrhage complication? how is it treated?

A
  • cerebral salt wasting (not SIADH)

- treat with salt