decreased concentration, personality changes, contralateral sensorimotor deficit of the extremities (face spared)
suggests a CVA in which artery?
anterior cerebral artery
no ipsilateral vision loss but contralateral visual field deficit, sensorimotor deficit, and CNVII palsy
dominant hemisphere: agnosia, R/L disorientation, agraphia, alexia
nondominant hemisphere: apraxia, hemi-neglect
suggests what artery CVA?
middle cerebral artery
contralateral hemisensory loss contralateral visual deficit cortical blindness color agnosia suggests a CVA where?
posterior cerebral
CVA resulting in: coma, diplopia, vertigo/ataxia/imbalance, weakness & sensory loss
where?
vertebrobasilar circulation
acute management of CVA? (4)
tx BP if > 200/100. IV Labetalol
anticoagulation: tPA, Heparin (short term), Coumadin (long term)
antiplatelet meds (Ticlopidine, Clopidigrel)
Statins
histories that would contraindicate TPA use? (6)
and how recently did these occur?
recent head trauma- 3 months hx intracranial hemorrhage hx of GI or GU hemorrhage (3 weeks) hx of major surgery (2 weeks) pregnancy HTN or use of anticoagulants
indications for carotid disease surgery
> 70% stenosis
acute onset of severe HA, N/V, associated w/ extreme increase in BP
intracerebral hemorrhage
risk factors for intracerebral hemorrhage? (4)
uncontrolled HTN
coagulation defects
pts on anticoag
recreational drug use
tx for intracerebral hemorrhage
control BP
anticonvulsants
control ICP
decompression for ICP
“worst HA of my life”
subarachnoid hemorrhage
N/V, nuchal rigidity, focal neuro deficits, severe acute HA
subarachnoid hemorrhage
stroke risk factors (5) for pt education
positive FH hx HTN hx tobacco use hx of hyperlipidemia hx A Fib
hospital red flags (3)
facial droop
arm drift
speech
ipsilateral monocular vision loss, contralateral visual field deficit, aphasia, contralateral sensorimotor deficit, contralateral CNVII palsy
signs of CVA in which artery?
internal carotid
