- Facial droop - Arm weakness - Speech difficulties - Time

Stroke Flashcards by Kelly Domogauer

stroke

The sudden loss of neurological function as the result of a disruption to blood flow resulting in tissue death

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two types of stroke

Ischemic

2. Hemorrhagic

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Risk factors for stroke (can be control)

o	Hypertension 
o	Smoking 
o	Hyperlipidemia 
o	Cardiac disease 
o	DM
o	Obesity (abdominal)
o	Sedentary lifestyle 
o	Excessive alcohol consumption

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risk factors for stroke that you cannot control?

o	Age
o	Sex
o	Heredity 
o	Race
o	Geography

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females or males more likely to have a stroke

males

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what race is higher for stroke

african americans

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geography that is more likely to have a stroke

southeast US

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warning signs of stroke include sudden effects of?

numbness (face, arm, leg)
dif speaking, understanding
trouble seeing (1 or 2 eyes)
walking, dizziness, LOB
severe headache

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when should you go to hospital if you think you had a stroke?

less then 3 hours: less disability

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What does FAST mean

Facial droop
Arm weakness
Speech difficulties
Time

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how is stroke usually diagnosed?

Non-contrast CAT scan

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What is given with the “Golden” 3 hours

tPA

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What is tPA

tissue plasminogen activator that results in lysis of fibrin (break up clot)

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What type of stroke uses tPA

ischemic

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MERCI procedure

Go through femoral artery to take clot out.

8 hour window

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University of Oxford ABCD Scale

performed in MD office

- predictor of stroke after TIA

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What is the standardized tool to assess impairment ?

NIH stroke scale

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score of 42 on NIH

Max score –> severe stroke

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what is a good outcome score on the NIH

12-20

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What score on the NIH will you see significant deficits ?

over 20

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80% of strokes are?

ischemic strokes

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Thrombotic onset is?

gradual

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Thrombotic symptoms

awaken

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embolic

A thrombus that originates elsewhere breaks away and is carried through bloodstream to a narrowing region

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onset of embolic

abrupt & often with activity

embolic common area of origin

cardiac, post surgery

ischemic attacks include

- lacunar infarct | - TIA

lacunar infarct

occlusion of small vessels

onset of lacunar infarct

gradual

lacunar infarct associated with

HTN & DM

TIA symptoms recover within

24 hours

Ischemic Penumbra

Rim of mild to moderately ischemic tissue around the area of infarction Is evolving

Brain requires ..... of regular blood flow to survive

20-25%

Hemorrhagic Stroke onset?

sudden

Hemorrhagic Stroke closely linked to

HTN

Hemorrhagic Stroke causes a decrease in

level of consciousness, heachache, nausea and vomiting

Hemorrhagic stroke includes (4)

oIntracerebral hemorrhage oSubarachnoid hemorrhage oSubdural hematoma oEpidural hematoma

Intracerebral hemorrhage

Arterial bleeding into the brain parenchyma

ICH results in

- Distortion of structures - Rise in intracranial pressure - Development of severe edema causing midline shift

Subarachnoid Hemorrhage

Blood in subarachnoid space

Subarachnoid Hemorrhage onset

sudden with a headache

most common cause of Subarachnoid Hemorrhage

AVM/ Berry aneurysm

Epidural Hematoma

Traumatic tearing of the meningeal arteries that supply the periosteal layer of the dura

what drugs need to be screen for with a epidural hematoma

cocaine

Where can a skull cap be kept during a craniotomy

frozen, abdomen

aphasia

difficulties in speaking, listening, reading, and writing, but does not affect intelligence

alexia

impairement in reading – knowing they are letters but unable to decode

agraphia

impairment in writing

apraxia

inability to execute a voluntary motor movement despite being able to demonstrate muscle function- understands requirement- present with and without paresis

Anosognosia

lack of awareness of illness

Dysarthia

motor speech disorder affecting respiration, articulation and phonation

Dysphagia

inability/ difficulty in swallowing due to CN involvement (CN V & VII, CN IX-XII)

Perseveration

unable to refrain from certain behaviors—NO brakes (might not be able to get off a specific topic)

Visual Perception

the ability to process incoming sensory information, to relate it to what you already known & to use it to generate functional outcomes, e.g. I recognize the comb & know to use it on my hair

Spatial Perception

ability to sense the size, shape, movement, distance, and orientation of objects & awareness of oneself in space and its relation to other objects

flexor synergy UE

- Scap retraction/ elevation - Shoulder abduction - Elbow flexion - Forearm supination - Wrist/ finger flexion

flexor synergy LE

- Hip flex/ abd/ er - Knee flex - Ankle df/ inv - Toe df

extensor UE

- Scap retraction - Shoulder add/ir - Elbow ext - Forearm pron - Wrist/ finger flex

extensor LE

- Hip ext/ add/ir - Knee ext - Ankle PF/INV - Toe PF

Anterior circulation responsible for how many CVA

less than 3%

most common region of CVA

Middle cerebral artery

common cause of middle cerebral artery CVA

internal carotid thrombus

most frustrating CVA population to work with

contraversive pushing/ pusher

pushers midlines are

18 to ipsilesional side

characteristics of pushers

oSpontaneous body posture – towards involvement oIncrease pushing force oResistance to passive correction posture Seated and standing posture

treatment for pusher includes

combination of visual, somatosensory, motor learning

what is complete basilar artery syndrome

locked in syndrome

Stroke Flashcards

(67 cards)