Stroke CC2 Flashcards Preview

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Flashcards in Stroke CC2 Deck (43)
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1
Q

most ischemic strokes are of ___ etiology

A

embolic (33%)

30% are large vessel

20% are small vessel

2
Q

___% of strokes are ischemic

A

83

3
Q

__% of strokes are intracerebral hemorrhage

A

10

4
Q

__% of strokes are subarchnoid hemorrhages

A

7

5
Q

#1 risk factor for strokes is

A

high bp

6
Q

nonmodifiable risk factors for stroke

A

age, sex, family history

7
Q

stroke mimics include (5)

A

1. hypoglycemia

2. mass lesions

3. seizures/postictal states

4. migraine

5. psychogenic hemiparesis

8
Q

contralateral hemiparesis (weakness on one side of the body) suggests ___ stroke

A

MCA

9
Q

sx of anterior division MCA stroke 

A

contralateral head & eye deviation

10
Q

sx of posterior division MCA stroke 

A

hemianopsia (contralateral visual field deficit),

11
Q

is ____ is occluded on the right side, what sx do you get neglect

A

posterior division MCA

12
Q

leg and foot deficits seen with 

A

ACA stroke

13
Q

what could cause cortical blindness

A

bilateral PCA stroke

14
Q

what is hemihypaesthesia? with what artery occlusion do you see it? 

A

complete loss of sensation of the contralateral face, arm, trunk and leg

 

seen with PCA

15
Q

signs of basialr/brainstem stroke 

A

altered consciousness & crossed signs:

 

cranial nerve deficit on one
side

hemiparesis or sensation loss of body on other side

16
Q

loss of perfusion to internal capsule by lenticulostriate causes __ sx 

A

pure motor hemiplegia (whole
side)

17
Q

loss of perfusion to thalamus by lenticulostriate causes __ sx 

A

pure sensory hypaesthesia (whole side)

18
Q

loss of perfusion to pons by lenticulostriate causes __ sx 

A

dysarthria, clumsy hand syndrome

19
Q

what do you use to rule out hemorrhage?

A

ct scan (shows up white)

20
Q

early infarct signs on a ct

A

1. hypodensity of grey or white matter


2. obliteration of cortical sulci

3. obscured basal ganglia

4. loss of insular ribbon

21
Q

aphasia indicates ___

A

L. hemispheric stroke 

22
Q

neglect / hemi-inattention indicates 

A

R. hemispheric stroke

23
Q

patients usually look ___ the lesion

A

toward

24
Q

crossed signs --> ___ involvement

A

brainstem

25
Q

vertigo of central origin usu. means 

A

other cranial nerve deficits

26
Q

vertical nystagmus is brainstem ____ until proven otherwise

A

ischemia

27
Q

tPA Indications and Contraindications Inculsion if: age___

A

less than 80

28
Q

tPA Indications and Contraindications Inculsion if: onset is

A

less than 3 hours

29
Q

tPA Indications and Contraindications Inculsion if: NIHSS ___

A

less than 24

30
Q

tPA Indications and Contraindications Inculsion if: ___ consent

A

informed

31
Q

tPA Indications and Contraindications EXCLUSION if: (danger zone)

A

- CT signs of hemorrhage or very large infarction


- undetermined time of onset


- uncontrollable hypertension or blood sugar


- recent trauma, major surgery or bleeding

- abnormal coagulation profile


- hemodynamic compromise from MI - rapidly resolving deficit

32
Q

tPA Risks and Benefits: treatment group had ___% more patients rated at “good outcome” after 3 months.

A

30

33
Q

risk of hemorrhage was __% with tPA treatment (1% without)

A

6

34
Q

hemorrhage after tpa --> __% mortality rate

A

50

35
Q

secondary risk prevention includes control of modifiable risk factors like 

A

HTN, diabetes, CAD, obesity

36
Q

___ new or recurrent strokes each year.

A

 600,000

37
Q

in terms of RR, which is the #1 risk factor of stroke

A

a. fib

38
Q

__ stenosis is a risk factor of stroke

A

carotid

39
Q

most common area affected by hemiparesis with right MCA stroke?

A

face=hand > arm > leg

40
Q

lacunar syndromes involves

A

pure motor hemiplegia from damage to the internal cpasule

41
Q

???

A

subarahnoid hemorrhage

42
Q
A

subdural hematoma

43
Q

what is this??

A

hyperdense MCA sign

early dx of stroke?

an appearance of increased attenuation of the proximal middle cerebral artery (MCA) that is often associated with thrombosis of the M1 MCA segment