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Flashcards in TIA/Stroke Deck (11):

Patient with suspected TIA. Next step?

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


Amaurosis fugax

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



Onset of focal neurologic deficit with spontaneous resolution within 24 hours


Differential for TIAs?

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


Types of focal neurologic symptoms?

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


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

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


Hollenhorst plaques?

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


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


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


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

Warfarin; blood pressure agents and antiplatelets


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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