Neuro: Cerebrovascular Disease

Question 1

What type of stroke?

diffuse, nonfocal sxs

circiulatory compromise

hypotension

bilateral sxs

Answer 1

hypoperfusion ischemic stroke

Question 2

Hypodense on CT indicates…

Answer 2

ischemia

Question 3

contralateral weakness/numbness face and arm > leg

contralateral homonymous hemianiopic gaze (look to lesion)

Answer 3

MCA stroke

Question 4

Dominant or non-dominant hemisphere MCA stroke?

(+) global aphasia

Answer 4

dominant hemisphere

Question 5

Dominant or non-dominant hemisphere MCA stroke?

(+) hemineglect

Answer 5

non-dominant

Question 6

contralateral weakness/numbness in leg > face/rm

(+) abuila (delay in response)

perseverating speech

Visual field deficits from CN impingement

Answer 6

ACA

Question 7

Contralateral homonymous hemianopia

reduced light-touch/pinprick sensation

may go unnoticed

Answer 7

PCA

Question 8

Ipsilateral loss pain/temp sensation on face

contralateral body loss of sensation

vertico, ataxia, hiccups, ipsilateral horners syndrome

Answer 8

Wallenberg’s syndrome/PICA

Question 9

Locked in syndrome

quadriplegia + facial/mouth/tongue weakness

EOMs and Blinking intact

Answer 9

basilar artery stroke

Question 10

stroke associated with chronic HTN

Answer 10

lacunar

Question 11

When to start BP tx for ischemic stroke…

Answer 11

220/120

Question 12

keep BP less than… for hemorrhagic stroke

Answer 12

160-90

Question 13

imaging of choice for stroke

Answer 13

non-contrast CT

Question 14

Tx for acute ischemic CVA…

Answer 14

ASA

Question 15

mechanical thrombectomy can be used for which strokes?

Answer 15

intracranial large artery proximal anterior

Question 16

Tx for hemorrhagic stroke

Answer 16

reduce ICP (elevate bed, mannitol, csf cath, etc)

stop anticoags + antidote

Question 17

What HTN med to keep BP < 160/90 in hemorrhagic stroke?

Answer 17

nicardipine

Question 18

3 imaging modalities to help lessen progression of TIA to CVA

Answer 18

EKG for afib

carotid ultrasound

CTA head and neck

Question 19

High risk HA + normal CT

Answer 19

LP for bleeding

Question 20

what population for SAH?

Answer 20

40-60 women

Question 21

leading causes of death after SAH

Answer 21

vasospasm (CVA)

re-bleeding

Question 22

On CSF analysis, RBCs decrease from tube 1 to tube 4… what does this indicate?

Answer 22

traumatic tap

Question 23

xanthochromia on CSF indicates…

Answer 23

SAH

Question 24

With SAH, what imaging must be ordered to monitor for vasospasm?

Answer 24

TCD

Question 25

SAH tx to prevent vasospasm

Answer 25

IV fluids + nimodipine