Anatomy of Stroke and Cerebrovascular Pathology

Question 1

Stroke

Answer 1

Acute neurological deficit resulting from cerebrovascular parthology that is definable radiographically

Question 2

Most common type of storoke

Answer 2

80% ischemic

20% hemorrhagic

Question 3

Ischemia vs hemorrhage

Answer 3

Isch - lack of oxygen resulting in permanent damage

Hemo - bleeding into a tissue

Question 4

How to image ischemic

Answer 4

DWI

Question 5

ELVO

Answer 5

Stroke due to occlusion of large vessels

Emergent large vessel occlusion

Question 6

Thrombectomy

Answer 6

Snake a catheter up through femoral artery and pull the clot out

Question 7

Causes of ischemic stroke

Answer 7

High clotting

Throbi:
Heart, legs through heart, intracranial stenosis, carotid stenossi

Question 8

SAH Mortality and morbidity and smyptoms

Answer 8

30% mortality
50% morbitidy

Headache, N/V, neck rigidity/pain, lethargy/coma

Question 9

Aneurysm rules

Answer 9

Vessel turns and branch points

Form in direction of lfow

Question 10

What happens when they hit the door?

Answer 10

ABCs

CT head

CSF diversion - ventriculostomy - in order to monitor pressure and also tx pressure

CTA or angiography

Tx

Question 11

Arteriovenous malformation

Answer 11

Looks like huge bleed in the brasin…need to make sure not to hit this

Question 12

Moya moya

Answer 12

Progressive occlusion/stenosis of bilateral ICAs

Can cause ischemic OR hemorrhagic stroke

Japanese

Could be syndrome if AI dz

Question 13

Moya moya tx

Answer 13

Aspriin, permissive hypertension

BYpass

Question 14

Most common intracranial occlusion site and txs for ischmiec stroke

Answer 14

MCA

IV tPA can be up to 4.5 hrs

Thrombectomy up to 12 hours

Question 15

After initial rescusitation, how do we protect patients from elevated ICP?

Answer 15

Ventriculostomy

Question 16

In moya moya what is cause of ischemia or hemorrhagic

Answer 16

ISchemia - lack of flow

Hemorrhagic - damage to abnormal collaterals