Strokes

Question 1

Fourth leading cause of death in the US

Answer 1

stroke

Question 2

Most common area for strokes

Answer 2

anterior circulation from internal carotid (2/3)

Question 3

Most common type of stroke

Answer 3

ischemic (80%)

Question 4

What does FAST stand for?

Answer 4

facial drooping, arm weakness, speech difficulty, time to call 911

Question 5

Most commonly affected vessel of anterior strokes

Answer 5

middle cerebral artery (96%)

Question 6

Sx include: Amaurosis fugax, Face-hand-arm-leg hemiparesis, Aphasia/dysarthria

Answer 6

Anterior circulation stroke

Question 7

Arteries that make up posterior circulation

Answer 7

Vertebral artery, Basilar artery, Posterior cerebral arteries

Question 8

Sx include: apraxia, aphasia, contralateral hemiplegia in face-arm-leg, person doesn’t recognize their body

Answer 8

MCA occlusion

Question 9

What circulation supplies the brainstem, thalamus, hippocampus, cerebellum, visual cortex, temporal lobes, occipital lobe?

Answer 9

posterior circulation

Question 10

Where are CN III and IV located?

Answer 10

midbrain

Question 11

Where are CN V, VI, VII, VIII located?

Answer 11

pons

Question 12

Where are CN IX, X, XI, XII located?

Answer 12

medulla

Question 13

Mortality associated with basilar artery occlusion

Answer 13

90%

Question 14

Sx include: vertigo, diplopia, sensorimotor deficits, dysarthria, ataxia

Answer 14

posterior circulation stroke

Question 15

What kind of stroke can have Ipsilateral face and contralateral limbs involvement?

Answer 15

Posterior circulation stroke

Question 16

5 D’s of posterior stroke

Answer 16

Dizziness, Diplopia, Dysarthria, dysphagia, dystaxia

Question 17

Sx include: HA, ataxia, nausea/vomiting, paralysis in tongue and swallowing all ipsilateral, Ipsilateral face and contralateral body

Answer 17

Vertebro-Basilar posterior circulation occlusion

Question 18

What type of stroke is more likely to have a severe HA?

Answer 18

hemorrhagic

Question 19

Secondary to the lenticulostriate arteries off the MCA

Answer 19

Lacunar strokes

Question 20

Type of stroke where patients deteriorate more rapidly and have H.A., N/V, and decreased consciousness as prominent signs

Answer 20

hemorrhagic stroke

Question 21

Type of hemorrhagic stroke that bleeds directly into brain tissue from small arterioles or arteries

Answer 21

Intracerebral

Question 22

Etiologies include: HTN, trauma, bleeding diathesis, vascular malformations (ruptured saccular aneurysms), AVM’s

Answer 22

intracerebral stroke

Question 23

Arteries and veins connected in such a way that there is no capillary bed at all resulting in higher than normal pressures in the veins

Answer 23

AVMs

Question 24

Type of hemorrhagic stroke due to rupture of an artery with bleeding onto the surface of the brain

Answer 24

subarchnoid hemorrhage

Question 25

Number one cause of subarchnoid hemorrhage

Answer 25

Aneurysm

Question 26

Sx include: worst HA of life, maximum intensity at onset, phono or photophobia, papillary edema

Answer 26

subarachnoid hemorrhage

Question 27

Most common causes of intracerebral hemorrhage

Answer 27

Hypertension, Amyloid angiopathy

Question 28

Drugs associated with hemorrhagic stroke

Answer 28

amphetamine and cocaine

Question 29

Characterized by impaired ability to speak and understand others and experience difficulty reading and writing

Answer 29

aphasia

Question 30

Type of aphasia where speech output is reduced to less than four words and difficulty reading/writing. Comprehension is intact

Answer 30

Broca's aphasia (expressive aphasia)

Question 31

Type of aphasia in persons who are left with a persistent inability to supply words for the things that they want to talk about.

Answer 31

anomic aphasia

Question 32

Type of aphasia characterized by few recognizable words, Understands little or no spoken speech, Can neither read or write

Answer 32

global aphasia

Question 33

What vessel supplies Broca's area?

Answer 33

superior division L MCA

Question 34

What vessel supplies Wernicke's area?

Answer 34

inferior division of the L MCA

Question 35

Aphasia where speech is fluent but meaningless and individual is unaware of language errors. Comprehension is poor

Answer 35

Wernicke's aphasia (receptive aphasia)

Question 36

What imaging should be ordered for acute work-up of stroke?

Answer 36

noncontrast brain CT

Question 37

Tasks covered by right hemisphere

Answer 37

analytical and perceptual

Question 38

Tasks covered by left hemisphere

Answer 38

speech and language

Question 39

Timeframe for treating strokes

Answer 39

window of opportunity is to treat stroke patients within 3-4.5 hrs. Patients need to get to hospital within 60 minutes

Question 40

After what period of time post stroke is complete recovery of aphasia unlikely

Answer 40

If symptoms last longer than two or three months

Question 41

NIH stroke scale classifications

Answer 41

0-no stroke. 1-4: minor stroke. 5-15: moderate stroke. 16-20: moderate to severe stroke. 21-42: severe

Question 42

Absent pulse in radial or carotid points to a diagnosis of....

Answer 42

Atherosclerosis with Thrombosis