cards

Question 1

greatest RF for stroke

Answer 1

Age
HTN

Question 2

When would you do a non contrast CT

Answer 2

Stroke w/u
Kidney stones

Question 3

Criteria for total anterior circulation stroke

Answer 3

All three of:
Unilateral weakness of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfx - dysphasia, visuospatial disorder

Question 4

Criteria for partial anterior circulation stroke

Answer 4

Two of:
Unilateral weakness or sensory deficit of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfx

Question 5

Types of anterior circulation strokes

Answer 5

Total anterior circulation strokes
Partial anterior circulation stroke
Lacunar syndrome

Question 6

Criteria for lacunar syndrome

Answer 6

one of:
Pure sensory stroke
Pure motor stroke
Sensori-motor stroke
Ataxic hemiparesis

Question 7

Criteria for posterior circulation syndrome

Answer 7

one of:
CN palsy + contralateral motor/sensory deficit
Bilateral motor/sensory deficit
COnjugate eye movement disorder
Cerebellar dysfx
isolated homonymous hemianopsia or cortical blindness

Question 8

Indications for thrombolysis in stroke

Answer 8

Within 4.5 hours of symptom onset
Intracranial hemorrhage r/o on imaging

Question 9

Indications for thrombectomy for stroke

Answer 9

Within 24hours of symptom onset
Acute ischemic stroke + confirmed occlusion of prox anterior circulation
+ potentially salvagable tissue

Question 10

Indications for thrombectomy + thrombolysis in stroke

Answer 10

Wihtin 24 hours of symptom onset
Acute ischemic stroke +confirmed occlusion of prox anterior circulation shown AND potentially salvagable brain tissue

Question 11

Aspirin indications stroke

Answer 11

Within 24hours of symptom onset and intracranial hemorrhage is excluded
Then daily aspirin for 2 weeks after onset of symptoms
Then definitive long term anti-thrombotic treatment

Question 12

When is medical managment given over surgical management in hemorrhagic stoke management

Answer 12

Small deep hemorrhage
Lobar hemorrhage without either hydrocephalus or rapid neurological deterioration
Large hemorrhage and significant comorbids before the stroke
GCS score <8 unless this is because of hydrocephalus
Posterior fossa hemorrhage

Question 13

When would you OFFER BP lowering in intracerebral hemorrhage

Answer 13

Present within 6 hours of symptom onset and SBP between 150-220mmHg
Aim for SBP 130-140mmHg within 1 hour of starting and maintain BP for at least 7 days

Question 14

When would you CONSIDER BP lowering in intracerebral hemorrhage

Answer 14

> 6 hours of symptom onset or has a SBP >220MMhG
Aim for SBP 130-140 mmHg within 1 hour of starting treatment and maintain this BP for at least 7 days