Cerebrovascular Accident Flashcards Preview

Neurology > Cerebrovascular Accident > Flashcards

Flashcards in Cerebrovascular Accident Deck (16):
1

ACA stroke px

-cognitive problems
-confusion
-contralateral weakness
-sensory loss in leg > arm
-incontinence

2

CVA types

Hemorrhagic (20%; HTN, excess anticoagulation; no therapy)

Ischemic (80%; thrombosis, emboli, systemic hypotension, vascular dissection)

2

Weber syndrome px
= branch of PCA stroke

-contralateral hemiplegia
-ipsilateral Cr III palsy

3

Benedikt syndrome px
= branch of PCA stroke

-contralateral ataxia or athetosis
-ipsilateral Cr III palsy

4

Wallenberg
= PICA stroke
= lateral medullary infarct

-ipsilateral facial sensory loss
-contralateral body sensory loss
-vertigo (fall to side of lesion)
-nystagmus
-ataxia
-dysarthria (ipsi vocal cord paralysis)
-dysphagia
-Horner's syndrome

5

left vs right dominant hemisphere

right vs left-handed

6

Romberg test

= testing for absence of proprioception by having patient closing their eyes

-usually have vision + proprioception + vestibular function
-need 2/3 to remain balanced

7

thrombolytic therapy administration time limit?

3 hours - TPA

-contrindications: major surgery, major HTN, high PT, coagulopathy, low platelets, head trauma/tumor/bleeding history

8

CVA dx

-CT = best initial
(rule out hemorrhagic)
-MRI = most accurate

-ischemic takes ~48 hours to appear on CT
-hemorrhagic appear immediately on CT

9

blood appears what color on CT?

white

10

CVD tx?
after 3 hours (negative CT)

-ASA
(prevents new stroke)

-add dipyridamole
-replace ASA with clopidogrel (ASA allergy)

11

heparin tx indications?

-Afib
-basilar artery actively thrombosing
-stroke in evolution

12

ticlopidine tx indications?

-NEVER

-SE: neutropenia, TTP
-give clopidogrel

13

warfarin tx indications?

-chronic Afib
(needs long term anticoagulation)

-INR = 2-3

14

diagnostics to find cause of stroke?

-echo: clot (warfarin), mitral stenosis (balloon)

-EKG: Afib (warfarin, INR = 2-3)

-carotid duplex: carotid stenosis: >70% stenosis (carotid endarterectomy)

15

stroke in younger patient (<50 YO) diagnostics?

-vasculitis: SLE, Wegener's

-hypercoagulable states: Factor V Leiden, protein C/S deficiency, antithrombin deficiency, lupus anticoagulant