3.21.14 38 Stroke Flashcards
What are the three main types of stroke?
Ischemic (85%) Intracerebral hemorrhage (10%) Subarachnoid hemorrhage (5%)
What are the 4 major sybtypes of ischemic stroke?
- Cardioembolism
- Large vessel disease (occlusion/embolism)
- Small vessel disease (lacunar)
- Hemodynamic (watershed, low BP)
What two methods are important for diagnosis of subarachnoid hemorrhage?
CT
If CT is inconclusive: LP
What is similar to ischemic stroke, but without focal ischemia on CT?
Transient ischemic attack
What is best for definitive diagnosis of TIA?
MRI
What is the normal cerebral blood flow? Penumbra? Core of a stroke?
50 ml/min/100g brain tissue
5-20 ml/min/100g
<5 ml/min/100g
What is the mnemonic for stroke diagnosis?
FAST --- Face Arms Speech Time
What symptomatically differentiates TIA from stroke?
TIA, sudden then goes away
Stroke, sudden and stays
What risk factors are associated with atherosclerosis (and therefore stroke)?
Age Gender Race (Black) Hypertension Diabetes mellitus Dyslipidemia Smoking
What is the standard of care for treatment of stroke?
IV tPA (if not hemorrhagic) Stroke care in specialized units
What should you avoid doing in case of stroke?
- Avoid treating HTN (salvage penumbra)
- Avoid giving glucose (damages penumbra)
- Avoid causing aspiration pneumonia
- Avoid tPA if hemorrhage is suspected
What are preventative measures for secondary stroke?
Antiplatelets Anticoagulants Lipid, BP, diabetes maintenance Surgical (carotid repair, extra/intracranial bypass) Lifestyle (smoking, diet, exercise)
Name the most common antiplatelet medication for strokes?
Aspirin
Name common anticoagulants
Warfarin, heparin
Name common lipid lowering medications
Statins
