Intro to Stroke Flashcards Preview

Week 21: Stroke > Intro to Stroke > Flashcards

Flashcards in Intro to Stroke Deck (25)
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1
Q

Ischemia vs infarction

A

Ischemia: inadequate blood supply to a tissue or organ
Infarction: area of dead tissue resulting from impaired blood supply

2
Q

TIA definition

A

Transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia
Without acute infarction

3
Q

Stroke definition

A

Neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia
With acute infarction

4
Q

Ischemic stroke

A

85%

Stroke resulting from occlusion of a blood vessel

5
Q

Hemorrhagic stroke

A

15%
Stroke resulting from rupture of a blood vessel
2 types: intracerebral hemorrhage and subarachnoid hemorrhage

6
Q

Are epidural and subdural hematomas considered hemorrhagic strokes?

A

No

7
Q

What arteries supply the cortex for the

  1. Legs
  2. Arms, hand and face
A
  1. ACA

2. MCA

8
Q

Left middle cerebral artery (MCA) stroke signs

A

Right hemiplegia (damage to precentral gyrus)
Right hemianesthesia (damage to postcentral gyrus)
Right homonymous hemianopsia (optic radiations)
Global aphasia (Wernickes and Brocas areas)
Left gaze deviation/preference (frontal eye fields)

9
Q

Homonymous hemianopsia

A

Where a person only sees one side of vision in each eye

10
Q

If you
1. stimulate
2. inhibit
frontal eye fields, which way will the eyes go?

A
  1. Contralateral eye movement (ex: seizure)

2. Ipsilateral eye movement (ex: stroke)

11
Q

Right middle cerebral artery (MCA) stroke symptoms

A
Left hemiplegia
Left hemianesthesia
Left homonymous hemianopsia
Left hemineglect (no aphasia, because language is on left)
Right gaze deviation/preference
12
Q

Left anterior cerebral artery (ACA) stroke symptoms

A

Right leg > arm weakness
Right leg > arm sensory loss
Frontal lobe behavioural abnormalities

13
Q

Left posterior cerebral artery (PCA) stroke signs

A

Right homonymous hemianopsia

If there is a proximal PCA occlusion, can also see right hemisensory loss and right hemiparesis

14
Q

“Top of the Basilar” stroke syndrome

A

Small perforator arteries supplying the thalamus and midbrain get blocked
Decreased level of consciousness (sometimes the only finding)
Varying degrees of: dysarthria, visual field deficit, eye movement abnormalities, weakness, ataxia, numbness)

15
Q

“Locked in” syndrome

A

Mid basilar occlusion (problem with the pons)
Bilateral horizontal gaze palsy (can only move eyes up and down)
Bifacial weakness (can only blink)
Anarthria (cannot speak)
Quadriplegia from damaged corticospinal tracts (cannot move)

16
Q

Lateral medullary syndrome

A

Vertebral artery or PICA occlusion
Vertigo, nausea, vomiting, ipsilateral Horner’s syndrome (ptosis, miosis, anhydrosis), hoarseness, dysarthria, dysphagia, ipsilateral facial numbness, contralateral body numbness, ipsilateral ataxia, hiccups
NO WEAKNESS (so often missed)

17
Q

4 symptoms of a cerebellar stroke

A

Ataxia (ipsilateral)
Nystagmus (beat towards lesion)
Dysarthria
Vertigo, nausea, vomiting

18
Q

3 main stroke mechanisms

A

Large artery atherosclerosis
Small vessel lacunar stroke
Cardioembolism

19
Q

Large vessel atherosclerosis disease

A

Can affect extracranial and intracranial vessels

Common sites: aortic arch, carotid bifurcations*, vertebral artery origins, etc

20
Q

Amaurosis fugax

A

Painless transient vision loss

Monocular or binocular

21
Q

Where is the lesion if the amaurosis fugax is

  1. monocular
  2. binocular
A
  1. Anterior to optic chiasm (eye or optic nerve) (ischemia from ipsilateral carotid artery)
  2. Optic chiasm or posterior (optic tracts/radiations or visual cortex)
22
Q

2 main causes of monocular transient vision loss

A

Carotid artery stenosis

Giant cell arteritis

23
Q

Small arteries in the brain can be damaged by what 4 diseases/activities

A

Hypertension
Hyperlipidemia
Diabetes
Smoking

24
Q

Small vessel disease leads to strokes in what 5 areas

A
Corona radiata
Basal ganglia
Internal capsule
Thalamus
Pons
25
Q

Cardioembolic strokes

A

Thrombus can form in the heart and then embolize to the brain
Most common cause by far is atrial fibrillation