Cerebrovascular Accident

Question 1

A variety of disorders characterized by the sudden onset of neurological deficits caused by vascular injury to the brain

Answer 1

Cerebrovascular Accident

Question 2

Epidemiology for CVA

Answer 2

Old > Young
M > F
Blacks > Whites

Question 3

Give at least 3 non-modifiable risk factors for CVA

Answer 3

Race
Age
Sex
Family hx
hx of stroke

Question 4

Give at least 3 modifiable risk factors for CVA

Answer 4

Cigarette smoking (nicotine - vasoconstrictor - ↑ BP)
Hypercholesterolemia (low density lipoproteins)
Obesity
HTN
DM (↑ glucose = thicken blood)
Asymptomatic Carotid Bruit (partial blockage - atheroma)
Transient Ischemic Attach (mini heart attack)

Question 5

Etiology of CVA

Answer 5

Ischemic (blockage)
Hemorrhagic (rupture)

Question 6

Classifications of Ischemic stroke

Answer 6

Thrombotic
Embolic
Lacunar

Question 7

known as a localized blood clot

Answer 7

Thrombus

Question 8

Most common classification of Ischemic stroke d/t gradual build up of clot/blockage

Answer 8

Thrombotic

Question 9

Most commonly affected artery in thrombotic ischemic stroke

Answer 9

MCA

Question 10

Differentiate Atherosclerosis vs Arteriosclerosis

Answer 10

Atherosclerosis (build-up of plaque)

Arteriosclerosis (hardening of arteries), usually brought about by age

Question 11

Abrupt type of ischemic stroke that is secondary to dislodging of thrombus from heart to brain

Answer 11

Embolic

Question 12

Type of stroke that affects perforating arteries/ small vessels (mvmt disorder)

Answer 12

Lacunar

Question 13

Type of stroke that affects LARGE BV (gradual onset) and usually occurs at night

Answer 13

Thrombotic

Question 14

Type of stroke that affects SMALLBV (sudden onset) and usually occurs during daytime activity

Answer 14

Embolic

Question 15

two types of hemorrhagic stroke

Answer 15

Intracerebral (ICH)
Subarachnoid (SAH)

Question 16

type of stroke that is chronic d/t prolonged HTN that commonly affects the PUTAMEN

Answer 16

Intracerebral Hemorrhage

Question 17

type of aneurysm that occurs in SMALL BV that commonly affects the PUTAMEN

Answer 17

Charcot-Bouchard Aneurysm

Question 18

type of aneurysm that occurs in MEDIUM TO LARGE BV that commonly affects the TUNICA ADVENTITIA

Answer 18

Saccular/ Berry Aneurysm

Question 19

Triad for Arteriovenous Malformation

Answer 19

Hemorrhage
Seizure
Migraine

Question 20

First major branch of the ICA

Answer 20

Opthalmic artery

Question 21

Identify if ACA/MCA/PCA
Medial side of frontal and Parietal lobe

Answer 21

ACA

Question 22

Identify if ACA/MCA/PCA
Lateral side of frontal, parietal, and temporal lobe

Answer 22

MCA

Question 23

Identify if ACA/MCA/PCA
Medial side of temporal and occipital

Answer 23

PCA

Question 24

Identify 4 arteries that supply the brainstem and cerebellum

Answer 24

Basilar a.
PICA (Posteroinferior cerebellar artery)
AICA (Anteroinferior cerebellar artery)
SCA (Supra/Superior cerebellar artery)

Question 25

Components of circle of Willis

Answer 25

Anterior Cerebral Arteries Posterior Cerebral Arteries Anterior Communicating Artery Posterior Communicating Arteries *Internal Carotid Arteries

Question 26

Identify what vascular syndrome is identified according to affectation (ICA/MCA/ACA/PCA) - Monocular blindness (L/R) - Aphasia - UE > LE

Answer 26

ICA

Question 27

Identify what vascular syndrome is identified according to affectation (ICA/MCA/ACA/PCA) UE and Face > LE Dysphagia Hemianopsia

Answer 27

MCA

Question 28

Right or Left MCA? ____ : pt is unaware of impairments ____ : pt is aware of impairments

Answer 28

Right non dominant (more problematic) Left dominant

Question 29

Identify what vascular syndrome is identified according to affectation (ICA/MCA/ACA/PCA) LE > UE Apraxia Urinary incontinence Abulia (Akinetic mutism) (+) grasp reflex/ sucking reflex

Answer 29

ACA

Question 30

Identify what vascular syndrome is identified according to affectation (ICA/MCA/ACA/PCA) Central post-stroke syndrome Neuropathic pain Memory deficit Visual impairment Prosopagnosia Visual Agnosia Dyschromatopsia Alexia s agraphia

Answer 30

PCA

Question 31

What are the 5 brainstem strokes (W,B,Li,Mg,W)

Answer 31

Weber: medial basal MB (CN3) Benedict: tegmentum of the MB (CN3) Locked-in: bilateral basal (all pons) Millard-gubler: lateral pons (CN5, CN7) Wallenberg: lateral medulla (CN5)

Question 32

Enumerate the 7 stages of recovery of Brunnstrom

Answer 32

1. Flaccidity 2. Beginning spasticity 3. Peak of spasticity - hardest 4. Declining spasticity 5. Further decline 6. Disappearance of spasticity 7. Fully recovered