Flashcards in CVA TIA, Pales II Deck (48)
1
aphasia
inability to speak (motor or sensory)
2
alexia
inability to read
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agraphia
inability to write
4
dysphagia
difficulty swallowing
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dysarthria
slurred speech
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hemispatial neglect
inability to attend one side of body or visual field
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apraxia
inability to perform a specific task
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anosognosia
unawareness of or denial of the existence of disability
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anomia
difficulty recalling words or names
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ataxia
unsteady gait
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what supplies basal ganglia
lenticulostriate
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lenticulostriate come off what a
MCA
13
Characteristics of MCA syndrome
contralateral hemiplegia/ sensation loss
contralateral homonymous hemianopsia
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dominant side MCA syndrome
aphasia, alexia, agraphia, acalculia, finger agnosia, R-L confusion
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non-dominant side MCA syndrome
unilateral neglect
dressing apraxia
anosognosia
constructional apraxia
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Anterior artery syndrome
contralateral sensory and motor loss of lower extremity
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PCA syndrome
homonymous hemianopsia
alexia without agraphia
visual or color anomia
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Lateral pontine syndrome
Marie-Fox syndrome
AICA
ataxia- arm and leg
weakness- upper and lower extremity
hemisensory loss- pain and temperature
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Lateral Medullary Syndrome
Wallenberg syndrome
PICA
facial sensory loss and pain
ataxia
nystagmus
vertigo
hoarseness
dysphagia
horner syndrome
hemisensory loss
hiccups
20
what strokes occur off basilar artery
locked in syndrome
lateral pontine
ventral pontine
ataxic hemiparesis
cortical blindness
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lateral gaze weakness and contralateral hemiplegia
ventral pontine syndrome
Raymond Syndrome
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contralateral UE and LE weakness
ipsi facial weakness
ventral pontine syndrome
Millard Gubler Syndrome
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quadriplegia, b/l facial paralysis, dysarthria
locked in syndrome
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other sx of stroke
HA
nausea/vomiting
stupor/coma/amnesia/confusion/delerium
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Amaurosis Fugax
transient mono ocular blindness
warning sign impending stroke
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causes of amaurosis fugax
embolic
hemodynamic
ocular
neurologic
idiopathic
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Sx of TIA
last less than 24 hours
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increased risk for what if have TIA
CVA within first 3 mo
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Dx of stroke
Hx: sudden onset
do complete neuro and mental status exam
CT w/o contrast (only detects big strokes)
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more sensitive imaging for stroke
MRI not CT
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looking for cause of stroke lab workup
Hx
lipids, blood glucose, cardiac enzymes
EKG, arrhythmia MI
echo
carotid doppler
MR-A/ CT-A
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differential for ischemic stroke
hemorrhagic or subdural hematoma
seizures
complex migraines
CNS tumors
nerves palsy
encephalitis
toxic metabolic encephalopathy
syncope
vertigo
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common cause for confusion of hospitalized patients
toxic metabolic encephalopathy
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Tx types for stroke
acute
primary stroke prevention
secondary stroke prevention
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acute Tx for stroke
rtPA (within 3 hrs)
Aspirin
IV fluids
keep BP sufficient, not too high
swallowing evaluation
early rehab
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non modifiable risk factors for stroke
age (>55)
+FMH
race: african american and hispanics>caucasians
gender: M>F
personal Hx TIA CVA MI any atherosclerosis
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modifiable risk factors for stroke
HTN!! second biggest
Afib
smoking
DM!!! biggest
carotid stenosis
HLD
physical inactivity and obesity
alcohol and drug abuse
geographic location
socioeconomic factors
38
stroke prevention efforst
diet (low sat fat)
exercise (aerobic 30 min 3-5 days)
strict control BP, sugars and cholesterol
quit smoking
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medications for stroke prevention
antiplatelets
anticoagulatns
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what are the antiplatelet drugs
aspirin
clopidogril
aspiring/dipyridamole
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what are the anticoagulation drugs
warfarin
heparin and LMWH
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tx options of carotid stenosis
depends on degree of stenosis
medical Tx
surgical Tx with endarterectomy
stents
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indications for stent in carotid stenosis
lesions not reachable with surgical approach
patients have high surgical risk
44
alexia without agraphia
PCA syndrome
45
multiple strokes all over brain
emboli from heart
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major risk factors for strokes
atherosclerosis and HTN
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CT can miss what
early strokes because small or in posterior circulation
48