Atherosclerotic Cerebrovascular Disease with CVA and TIA - Pales Flashcards by Matt Stanton | Brainscape

Q

3rd leading cause of death in US

A

stroke

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Q

CVA

A

stroke

abrupt onset of neuro eficit - attributable to focal vascular cause

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Q

types of strokes

A

hemorrhagic

ischemic (majority)

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Q

ischemic penumbra

A

brain tissue around necrosis that is reversible - with appropriate tx

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Q

large artery thrombosis

A

rupture of plaque with fibrous plaque

blood clot forms - occluding artery

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Q

emboli

A

from atherosclerotic plaque or thrombus

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Q

paradoxical emboli

A

from lower leg DVT

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Q

atrial cardiac emboli

A

A-fib
atrial septal aneurism
tumor - myxoma

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Q

A-fib

A

fast/ineffective atrial contraction

-stasis and thrombus formation

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Q

atrial septal aneurysm

A

weak and outpouch of septum - stasis and thrombus formation

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Q

atrial myxoma

A

piece of tumor tear off and embolize

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Q

ventricular emboli

A

cardiomyopathy
MI
ventricular aneurysm

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Q

cadiomyopathy

A

weak dilated ventricle - stasis and thrombi formation

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Q

libman sacks endocarditis

A

with SLE

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Q

marantic

A

non-bacterial thrombi from cardiac source

malignancy or hypercoag state

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Q

tighter the stenosis

A

higher risk of stroke

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Q

hole in heart

A

with paradoxical emboli

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Q

lacunar infarct

A

subcortical areas of brain
-asymptomatic/minor sx

large artery branch to small artery right away - get lipohyalinosis from high pressure

hyperplasia and hyalinosis of vessel walls - narrow and occluded

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Q

watershed infarct

A

with profound hypotension

sepsis, bleeding, dehydration

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Q

hemostasis

A

3 parts working other

coag system
anticoag system
thrombolytic system

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Q

hypercoagulable state

A

factor V - leiden mutation
protein C and protein S
antithrombin deficiency
plasminogen deficiency
prothrombin mutation

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Q

antiphospholipid Ab syndrome

A

arterial clotting

anticardiolipid Abs
lupus anticoagulantas

hyperhomocysteinemia

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Q

hyperhomocysteinemia

A

hypercoag

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Q

other hypercoag states

A

pregnancy
cancer
HRT
prolonged bed rest/immobile
myeloproliferative

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Q

vasculitis

A

inflammed vessels

-cause of stroke

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Q

vasospasm

A

cocaine use

stroke

Q

moyamoya disease

A

large intracranial artery occlusion

Q

stroke presentation

A

depend on size of vessel

area of brain supplied by vessel

Q

weakness of one side of body

A

hemiparesis

Q

paralysis of one side of body

A

hemiplegia

Q

loss vision same visual field both eyes

A

homonymous hemianopia

Q

difficulty perform math

A

acalculia

Q

difficulty recognize object, people, sounds, shapes, etc.

A

agnosia

Q

inability to speak

A

aphasia

Q

inability to read

A

alexia

Q

inability to write

A

agraphia

Q

difficulty swalowing

A

dysphagia

Q

slurred speach

A

dysarthria

Q

inability to attend to one side of body

A

hemispatial neglect

Q

inability to perform specific task

A

apraxia

Q

unawareness or denial of existance of disability

A

anosognosia

Q

difficutly recall words or names

A

anomia

Q

unsteady gait

A

ataxia

Q

middle cerebral artery syndrome

A

C/L hemiplegia - face and upper extremities

C/L homonymous hemianopia

dominant - aphasia, alexia, agraphia, acalculia

non-dominant - hemineglect, dressing apraxia, anosognosia

Q

posterior cerebral artery syndrome

A

homonymous hemianopia, alexia without agraphia - can’t read - can write**
visual or color anomia

Q

lateral pontine syndrome

A

marie foix syndrome
anterior inferior cerebellar a

ataxia - arm and leg
weak upper and lower extremity
hemisensory loss - pain and temp

Q

lateral medullary syndrome

A

wallenberg syndrome
posterior inferior cerebellar a

facial sense loss/pain
ataxia
nystagmus
vertigo
hoarse
dysphagia
horner syndrome**
hemisensory loss
hiccups

Q

locked in syndrome

A

quadriplegia, B/L facial paralysis, dysarthria

Q

ventral pontine syndrome

A

raymond syndrome

lateral gaze weakness
C/L hemiplegia

Q

millard-gubler syndrome

A

ventral pontine syndrome

C/L upper/lower extremity weak
C/L hemiplegia

Q

ataxic hemiparesis

A

C/L upper/lower extremity weakness and ataxia

Q

anton syndrome

A

cortical blindness

blindnes and denial

Q

amaurosis fugax

A

temporary one eye blindness

warning sign of stroke

embolic - carotid artery

also - hemodynamic, ocular, neuro, idiopathic

Q

TIA

A

stroke lasts less than 24 hours

10% risk of CVA within first 3 months

Q

diagnosis of stroke

A

neuro and mental status exam

CT without contrast
MRI - very sensitivte

Q

CT and stroke

A

to rule out bleeding - so can give clot buster or not

Q

lower face only affected

A

with central bells palsy - CN VII

Q

tx of stroke

A

acute tx
primary stroke prevention
secondary stroke prevention

Q

acute tx of stroke

A

rtPA and aspirin

IV fluid - keep BP sufficient for saving penumbra

swallowing eval

early rehab

Q

non-modifiable stroke risk fx

A

age
fam hx
race - AA and hispanics
gender - men
med hx

Q

modifiable stroke risk fx

A

HTN
A-fib
smoking
DM
carotid stenosis
hyperlipidemia
obesity
alcohol/drug use

Q

stroke prevention

A

diet
exercise
control BP, blood sugar, cholesterol

quit smoking

Q

stroke prevent meds

A

aspirin
clopidogril
ASA, dipyridamole

warfarin, heparin, LMWH