what is atherothrombotic ischemia?
stenosis of the blood vessel itself
what is a cardioembolic ischemia?
a embolus is formed in the heart and travels to the brain where it causes a stoppage
what is the most common primary heart tumor?
myxoma
who is at risk for hemorrhagic stroke?
if they are young, its likely that they drink a lot and smoke a lot
what is a TIA?
any neurological dysfunction without acute infarction
what if imaging shows a stroke?
call it a stroke
why is it important to be aggressive with TIA?
you may be able to identify reversible things that will help prevent a stroke for them
when can you rule out subarachnoid hemorrhage?
negative CT negative LP (no blood, no xanthochromia)
what is a lacunar infarct?
due to HTN
small vessel disease deep within the brain
why do you need to be careful when overcorrecting high blood pressure?
bringing it too low too quickly will decrease pressure to the brain
what role does a CT serve in the case of an ischemic stroke?
rules out hemorrhagic stroke so you can give them a thrombolytic
how does an embolic stroke present?
occur suddenly, maximal at onset
how does a thrombotic stroke present?
sxs fluctuate
stepwise progression
may stutter
how does a large artery present?
evolves over a long period of time
how does a penetrating artery stroke present?
develops over hours to days
how does an ICH present?
neurological sxs get worse gradually over a course of hours
how does an SAH present?
develops instantly
“thunderclap” headache
what is hemorrhagic transformation?
once there is an area of dead brain tissue, you are more likely to bleed into that area
what is common for stroke in terms of heart testing?
TTE with bubble studies (if bubbles cross over, it suggests PFO)
when is a TEE indicated?
TTE looked funny
suspect for myxoma, endocarditis
obese pts or other body habitus prevents good TTE imaging
what are the DOC for IV management of HTN during an ischemic stroke?
nicardipine
labetalol
lower 15%, slowly and only if BP is >220/120
