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Flashcards in TIA/Stroke Deck (11):
0

Patient with suspected TIA. Next step?

High resolution carotid ultrasound or MRA to evaluate for carotid artery stenosis

1

Amaurosis fugax

Transient monocular blindness caused by ischemia to the retinal artery. Described as shade being pulled down.

2

TIA?

Onset of focal neurologic deficit with spontaneous resolution within 24 hours

3

Differential for TIAs?

Migraine, postictal paralysis, seizures, subdural hematoma, abscess, tumor

4

Types of focal neurologic symptoms?

1 amaurosis fugax
2 hemiparesis
3 heavy anesthesia
4 aphasia
5 dizziness/vertigo

5

Most common causes stroke/TIA and which part of the brain they affect?

1. Carotid atherosclerosis
2. Cardioembolism– MCA
3. Lipohyalinosis– lenticulostriate arteries

6

Hollenhorst plaques?

Cholesterol emboli that often lodge in with no artery causing amaurosis fugax

7

Pros and cons of noncontrast CT scan brain?

Pro: very sensitive at detecting acute cerebral hemorrhage

Con: insensitive to acute ischemic strokes, especially if stroke is small (<12 hours) or located in the brainstem

8

Stroke prevention - drugs?

Do not use this combination of drugs?

Antiplatelet therapy.

Plavix or combination of aspirin and dipyridamole > aspirin alone

Plavix + aspirin does not provide greater stroke prevention and increases bleeding

9

Long-term drug treatment for patients with AFIB? For patient with Lacunar infarcts?

Warfarin; blood pressure agents and antiplatelets

10

Surgical interventions reduce long-term risk of stroke? Use especially in which patients?

Carotid endarterectomy. Benefits begin after two years post surgery so use in patients with long life expectancy

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