Neurology 3.5 Flashcards Preview

NMSK-B III > Neurology 3.5 > Flashcards

Flashcards in Neurology 3.5 Deck (28):
1

What is a stroke?

injury to the brain caused by interruption of blood flow or bleeding into or around the brain, retina, or spinal cord

2

What are the major mechanisms which produce stroke?

blockage of an artery; ischemia (80%)

rupture of artery; hemorrhage (20%)

3

Who is most likely to have a stroke?

older African Americans with comorbidities

4

What is the clinical presentation of stroke?

-weakness or paralysis
-loss of sensation
-vision problems
-difficulty with speech and understanding
-difficulty with organizing thought
-clumsiness or lack of balance

5

What would a patient look to one side of the body after a stroke?

In a stroke the pt will look towards the side of injury

6

What are the key functional areas of the anterior cerebral artery?

-leg and foot
-control urinary bladder

7

What are the key functional areas of the middle cerebral artery?

-face and arms
-frontal/parietal: langauge and visuospatial

8

What are the key functional areas of the vertebral-basilar circulation?

-brainstem and cerebellum
-most of thalamus and hypothalamus
-cortex and deep white matter

9

What are the key functional areas of the posterior cerebral artery?

visual radiations and primary visual cortex
hippocampus

10

What is the clinical presentation of damage in the carotid territory?

-one-sided limb weakness, clumsiness, paralysis
-one-sided numbness, paresthesia, sensory loss
-language difficult
-dysarthria (inability to articulate words)

11

What is the clinical presentation of damage in the vertebral-basilar territory?

-vertigo or dizziness
-weakness or clumsiness
-numbness or sensory loss
-limb ataxia or coarse tremor, staggering gait
-dysarthria
-visual field defect, blindness, diplopia
**unilateral or bilateral

12

What is TIA?

transient ischemic attack;
brief episode in which neurologic deficits suddenly occur then disappear

13

Why do patients often ignore TIAs?

episode of impaired function is brief

14

What is TMB?

transient monocular blindness; retina becomes temporarily ischemic

15

What is the clinical presentation of TMB?

gray or black fog or mist clouding vision in all or part of one eye

16

What is the first test we do when a patient presents with stroke-like symptoms?

non-contrast CT

17

What is a lacunar stroke?

small subcortical infarcts in the territory of deep penetrating arteries

18

What are the common sites for a lacunar stroke?

-basal ganglia
-internal capsule
-thalamus
-corona radiata
-pons

19

What is a putamen?

smalla rtery which is damaged in a lacunar stroke

20

What are the 4 classic lacunar stroke syndromes?

1) pure motor stroke/hemiparesis
2) pure sensory stroke
a. persistent or transient numbness +/- tingling on one side
b. pain, burning, unpleasant sensation [thalamus]
c. clumsy hand dysarthria, slurred speech, impaired coordination [pons, internal capsule, basal ganglia]

21

What is the main difference between a lacunar stroke and an ischemic stroke?

no aphasia or visual field loss in lacunar

22

Which common ailment is often confused with a stroke?

hypoglycemia

23

What is the treatment for a stroke?

-alteplase (dissolves thrombus) aka "tpa"
-may be given if symptoms began 4.5 hrs prior or less

24

What is the action when a patient arrives with stroke-like symptoms after 10 minutes?

evaluate patient for potential stroke

25

What is the action when a patient arrives with stroke-like symptoms after 15 minutes?

notify stroke team

26

What is the action when a patient arrives with stroke-like symptoms after 25 minutes?

initiate head CT

27

What is the action when a patient arrives with stroke-like symptoms after 45 minutes?

interpret CT

28

What is the action when a patient arrives with stroke-like symptoms after 60 minutes?

administer IV rt-PA