420 Ischemic Stroke Flashcards
A decrease in cerebral blood flow to zero causes death of brain tissue within how many minutes? (H20 C420 P3079)
4-10 mins
A decrease of cerebral value to this value will cause brain infarction within an hour (H20 C420 P3079)
<16-18 mL/100 g tissue per minute
Defined as the ischemic but reversibly functional tissue surrounding a core area of infarction (H20 C420 P3079)
Ischemic penumbra
Hyperglycemia (blood glucose above this value) dramatically worsens brain injury during ischemia (H20 C420 P3080)
> 11.1 mmol/L (>200 mg/dL)
When faced with competing demands of myocardium and brain, this drug class can be a first step to decrease cardiac work and maintain blood pressure (H20 C420 P3080)
Beta1-adrenergic blocker
In ischemic stroke, cerebral edema peaks on the second and third day but can cause mass effect for how many days? (H20 C420 P3080)
~10 days
Hemicraniectomy reduces mortality in ischemic stroke by 50%. However, patients of this age benefit less. (H20 C420 P3080)
> 60 years
Predictor of deterioration requiring hemicraniectomy in acute ischemic stroke (H20 C420 P3080)
Size of the diffusion-weighted imaging of brain infarction
The presence of these symptoms should alert the physician to consider cerebellar stroke due to vertebral artery dissection (H20 C420 P3080)
Head or neck pain
Major surgery in the preceding how many days is a contraindication to IV rTPA in AIS (H20 C420 P3081)
14 days
Gastrointestinal bleeding in the preceding how many days is a contraindication to IV rTPA in AIS (H20 C420 P3081)
21 days
Sustained BP above these values despite treatment is a contraindication to IV rTPA in AIS (H20 C420 P3081)
> 185/110 mmHg
For decline in neurologic status or uncontrolled BP during rTPA infusion, this is given and the brain is reimaged emergently (H20 C420 P3081)
Cryoprecipitate
Standard dosing of IV rTPA (H20 C420 P3081)
0.9 mg/kg (max 90 mg), 10% as blous then the rest as 60 min infusion
Lower dose of rTPA that is safer in Asians and has similar outcomes (H20 C420 P3081)
0.6 mg/kg
Endovascular therapy improved outcomes for internal carotid and MCA occlusions proven by CTA, with or without pretreatment of IV t-PA, if performed within how many hours of stroke onset? (H20 C420 P3081)
6 hours
The only antiplatelet agent that has been proven to be effective for the acute treatment of ischemic stroke (H20 C420 P3082)
Aspirin
Hypothermia in acute ischemic stroke is associated with an increase in this complication that could adversely impact stroke outcomes (H20 C420 P3082)
Pneumonia
The use of this physical therapy has beens shown to improve hemiparesis following stroke (H20 C420 P3082)
Constrained movement therapy
Of the routine diagnostics for patients with acute ischemic stroke, only these two are necessary prior to IV rTPA (H20 C420 P3082)
Brain imaging, capillary blood glucose
The most significant cause of cardioembolic strokes in most parts of the world (H20 C420 P3082)
Nonrheumatic atrial fibrillation
A left atrium of this diameter is an indication for oral anticoagulation in rheumatic mitral valve disease regardless whether atrial fibrillation is present (H20 C420 P3084)
55 mm
Dominant vascular mechanism causing large-vessel brain ischemia (H20 C420 P3083)
Artery-to-artery embolism
Most common sources of embolus causing stroke in carotid atherosclerosis [2] (H20 C420 P3083)
Common carotid bifurcation, proximal internal carotid artery