5

Question 1

2 major types of ischemic stroke?

Answer 1

arterial (much more common) and venous

Question 2

2 types of hemorrhagic stroke?

Answer 2

intracerebral and subarachnoid

Question 3

What is it called when there is a sudden onset of focal neuro deficit for less than 24 hours, no brain injury on imaging, 1 hour duration

Answer 3

transient ischemic attack

Question 4

What are the 4 ischemic stroke subtypes?

Answer 4

atherothrombotic, cardioembolic, lacunar, other

each accounts for approximately 25%

Question 5

What are the 4 risk risk factors for atherthrombotic stroke?

Answer 5

hypertension, diabetes, elevated cholesterol, and smoking

Question 6

How is an antherothrombotic plaque prevented?

Answer 6

anti platelet drugs, statins, surgical measures

Question 7

What percentage of patients who have had a stroke had a prior TIA?

Answer 7

10%—highest risk within a week, then month, then year

Question 8

Where are the common locations for atherosclerosis in the brain arteries?

Answer 8

at the turns and branching points of the vascular system

Question 9

most common brain arteries effected by a cardioembolic stroke?

Answer 9

MCA and PCA

Question 10

What is the hallmark sign of a cardioembolic stroke?

Answer 10

affects multiple vascular territories in the brain

Question 11

How do you prevent cardioembolic stroke?

Answer 11

anticoagulants

Question 12

What is the most common cause of cardiembolism?

Answer 12

atrial fibrillation (50%)

Question 13

What type of stroke is made from occlusion of small penetrating arteries producing small holes?

Answer 13

lacunar—-vessel wall is thickened (hyaline) due to hypertension and diabetes, associated with better prognosis

Question 14

What can arise from recurrent lesions from ischemic stroke in the long run?

Answer 14

multi-infarct dementia

Question 15

What areas does lacunar stroke typically effect?

Answer 15

putamen, caudate, thalamus, pons, internal capsule, basal ganglia

Question 16

What type of cause of stroke is this? - clots formed at site of intimal flap may occlude and is more commonly seen in trauma and young adults

Answer 16

Arterial dissection

Question 17

Can you lose almost 2 million neurons each minute after a stroke?

Answer 17

yes, every minute counts

Question 18

Do acute infarcts show up a few days later or right away on MRI?

Answer 18

often a dew days later

Question 19

Are there currently drugs on the market for neuroprotective behavior?

Answer 19

None of proven efficacy

Question 20

Symptoms of an intracerebral hemorrhage?

Answer 20

headache prominent, nausea, vomiting, impaired consciousness

Question 21

Are there types of arteriopathy hemorrhagic strokes?

Answer 21

yes–chronic hypertension, amyloid antipathy, vascular malformations

Question 22

What are the 4 hemorrhagic stroke management strategies in order?

Answer 22

1. stop bleeding (BP control)
2. Manage brain edema
3. Manage hydrocephalus
4. Treatable Cause

Question 23

Where are the most common locations for aneurysms?

Answer 23

branch points, may be multiple

Question 24

Most common presentation of aneurysm?

Answer 24

sudden increase in ICP, Headache, decreased alertness

Question 25

Do patients with subarachnoid hemorrhage display cardiac symptoms along with worst headache etc?

Answer 25

it is possible, due to cathecolamines

Question 26

Do CT scans for subarachnoid hemorrhage get more or less positive with time?

Answer 26

Less, 98% within 24 hrs, 50% at 7 days

Question 27

What is another test besides CT if subarachnoid hemorrhage is still the differential?

Answer 27

lumbar puncture–xanthochromia due to blood breakdown (compare it with clear water

Question 28

Steps towards management of aneurysm>

Answer 28

1. Image to find
2. secure aneurysm
3. manage vasospasm
4. manage hydrocephalus
5. seizure control
   6 medical complications

Question 29

What are the risk factors for rupturing an unruptured aneurysm?

Answer 29

smoking, hypertension, family history, size, location