ABCN Deck 2

Question 1

Perinatal stroke refers to strokes occurring between ____ weeks gestation and the first ____ days of life.

Answer 1

20, 28

Question 2

In adults, following stroke, ________ has been shown to dissolve the occlusive clot and increase the probability of restoring blood flow to the surrounding ischemic penumbra. However, its use is limited by the need to provide treatment within ___ to ___ hours of symptom onset.

Answer 2

tissue plasminogen activator; 3 to 4.5

Question 3

AD accounts for __% of dementia cases.

Answer 3

70

Question 4

In AD the ____ lobe and _____ areas are where most atrophy occurs.

Answer 4

temporal, association

Question 5

amyloid deposition in blood vessels, resulting in repeated hemorrhage, ischemic infarction, cognitive loss.

Answer 5

cerebral amyloid angiopathy.

Question 6

_______ dementia is characterized by deficits in episodic memory (acquisition, storage), progressive social withdrawal, increased apathy; followed by deficits in other cognitive domains including language, EF, attention, processing speed, and visuospatial skills.

Answer 6

Alzheimer’s

Question 7

Mixed pathology was found in __% of vascular dementia cases, with ___ + VAD being the most common.

Answer 7

77, AD

Question 8

Lacunar infarcts of the ___, ___, & ___ may have disproportionate dysarthria, impaired gait, pseudobulbar palsy, and loss of initiation.

Answer 8

basal ganglia, thalamus, related white matter

Question 9

The lesions of AD consistent of synaptic and neuronal loss associated with progressive deposition of ___ in the form of diffuse ___, along with accumulation of ___ in the form of ______ and ______.

Answer 9

amyloid, neuritic plaques, tau, neurofibrillary tangles, neuropil threads.

Question 10

Most common cause of intracranial hemorrhage in children

Answer 10

Trauma

Question 11

____ scans are sensitive to lacunar infarcts, which are “silent” but can be extensive enough to produce neurocognitive deficits.

Answer 11

MRI

Question 12

The neuropathological functional progression of AD: early stages? followed by?

Answer 12

early stages: hippocampus & entorhinal cortex; followed by: frontal, temporal, parietal association areas

Question 13

Common risk factors for ____ include: maternal infertility, preeclampsia, prolonged rupture of membranes, chorioamnionitis, prothrombotic states or thrombophilia

Answer 13

perinatal ischemic stroke

Question 14

Up to __ % of people over age 65 have symptoms consistent with AD

Answer 14

10

Question 15

Vascular dementia associated with increased periventricular white matter signal, lacunar infarcts, sparing of subcortical U fibers, slowly progressing clinical course. Validity of this disease has been called into question.

Answer 15

Binswanger’s disease

Question 16

In ___, primary motor, visual, auditory, and somatosensory cortices tend to be relatively unaffected until quite late in the disease process.

Answer 16

AD

Question 17

acute presentation of stroke in the posterior circulation in children can present as

Answer 17

ataxia, vertigo, or vomiting

Question 18

Where is the infarct? L leg weakness & sensory loss. Sometimes, grasp reflex, EF deficits, and L hemineglect. Larger infarcts may cause L hemiplegia

Answer 18

Right ACA

Question 19

The prevalence of vascular dementia has been reported to be ___% in persons older than ___, with prevalence rates doubling every ___ years.

Answer 19

2.4%, 70, 5.3

Question 20

Less than __% of patients with AD are believed to have a familial variant of the disease. These cases are typically early-onset (ages 40-60), with more rapid decline.

Answer 20

5

Question 21

Depression is present in ___ to ___% in adult patients with stroke.

Answer 21

20 to 30%

Question 22

common risk factors for childhood ________: cardiac disease, cerebral arteropathies, infection

Answer 22

ischemic stroke

Question 23

Where is the infarct? R leg weakness, R leg sensory loss. Sometimes, grasp reflex, EF deficits, transcortical motor aphasia. Larger infarcts may cause R hemiplegia.

Answer 23

Left ACA

Question 24

A _____ scan can detect infarcts within minutes of symptom onset.

Answer 24

diffusion weighted MRI

Question 25

Which vascular dementia presents with apathy, impaired attention, and memory dysfunction?

Answer 25

subcortical ischemic vascular disease (SIVD)

Question 26

_____ are the most common acute presentation of AIS in childhood.

Answer 26

seizures

Question 27

Which strategic infarct syndrome? disruption of various executive and motor functions

Answer 27

caudate nucleus, globus pallidus, thalamus

Question 28

___% of strokes are thromboembolic/ischemis and ___% are hemorrhagic (in adults).

Answer 28

88, 12

Question 29

Relative risk for stroke _____ every decade after ___ years.

Answer 29

doubles, 55

Question 30

Donepezil (Aricept), Rivastigmine (Exelon) and Galantamine (Razadyne) are ____ which may slow disease progression of AD in some patients.

Answer 30

acetylcholinesterase inhibitors

Question 31

hereditary, nonatheroscloerotic arteriopathy affecting the cerebral small vessels, resulting in diffuse white matter disease and small lacunar infarctions. Patients often present with migraine, seizures, depression, TIA, and stroke in the frontal and subcortical areas. Rare disease.

Answer 31

CADASIL

Question 32

During disease progression of AD, there is subsequent reduction in the production of the following neurotransmitters:

Answer 32

choline acetyltransferase, serotonin, norepinephrine

Question 33

Infarct location? R homonymous hemianopia. Sometimes, alexia w/o agraphia. Larger infarcts may cause transcortical sensory aphasia, R hemisensory loss, R hemiparesis. Memory deficits may be present.

Answer 33

L PCA

Question 34

Demographic risk factors for vascular cognitive impairment include (2)

Answer 34

advancing age, African American, Native American, Latin American ethnicity

Question 35

Etiology of hemorrhagic strokes is most commonly _____ (___%).

Answer 35

hypertension, 50%

Question 36

Which strategic infarct syndrome? Gerstmann syndrome, constructional dysfunction

Answer 36

left angular gyrus

Question 37

The _____ circulation includes the anterior cerebral, middle cerebral, and anterior choroidal arteries. ____% of strokes occur here.

Answer 37

anterior circulation; 80%

Question 38

___ is the single largest known risk factor for AD. Having a ____ increases risk.

Answer 38

age, first-degree family member

Question 39

____ strokes are associated with higher mortality; ______ strokes have mortality of 50% in the first 6 months after stroke.

Answer 39

hemorrhagic; subarachnoid

Question 40

acute presentation of hemorrhagic strokes in infants and young children can include ____. In older children, presentation may include ___.

Answer 40

altered mental status, convulsions; severe headache.

Question 41

The ____ is used to assess for stroke symptom severity. it has a maximum score of ___, which reflects severe impairment. Clinicians rate (9 domains).

Answer 41

NIH Stroke Scale. 42. visual fields, facial, arm, and leg paralysis, limb ataxia, somatosensory sensation, language, dysarthria, and extinction.

Question 42

Infarct location? L homonymous hemianopia. Larger infarcts may cause L hemisensory loss & L hemiparesis. Memory deficits may be present.

Answer 42

R PCA

Question 43

nontraumatic hemorrhagic stroke in children is usually associated with ______ or _______.

Answer 43

intracranial vascular abnormalities (AVM’s) or medical disorders (brain tumors).

Question 44

acute presentation of AIS in children include

Answer 44

altered mental status

Question 45

In adults, 6 months after subarachnoid hemorrhage, ___% continue to have cognitive impairment with impaired ADL’s.

Answer 45

33%