Cerebrovascular disease

Question 1

Types of possible vascular damage and which is more common

Answer 1

Ischemic and hemorrhagic

Ischemic more common

Question 2

Cardinal signs of hemorrhagic event?

Answer 2

HA, N&V and seizures

Question 3

Other signs of cerebrovascular event?

Answer 3

Hemiparesis, hemianopsia
Facial droop, monocularity, slurred speech and altered consciousness
Can last for days if stroke.
Strokes worse than TIA

Question 4

Causes of artery dissection

Answer 4

CV dz and trauma

Question 5

How to estimate chances of stroke 2 days after TIA

Answer 5

ABCD^2
Age >60
BP > 140/90
Clinical features (unilateral weakness and speech fail)
Duration > 1 hour
Diabetic pt

Question 6

TIA workup

Answer 6

MRI with DWI

MRA/CTA (see aneurysm)

Question 7

Treatment of TIA

Answer 7

Control CV risk factors
Antiplatelets to decrease clots
Carotid endarterectomy
Carotid angioplasty/stenting

Question 8

Risk factors of intracerebral hemorrhage?

Answer 8

Trauma, HTN, blood thinners and age

Question 9

What type of ischemia most likely?

Answer 9

Lacunar infarcts

Question 10

What type of hemorrhage is most likely?

Answer 10

Lacunar infacts

Question 11

Key finding for subarachnoid hemorrhage?

Answer 11

Worst effing headache of my life, man

Question 12

Diagnosing subarachnoid hemorrhages

Answer 12

CT and MRA/CTA

Lumbar puncture = RBCs and increased pressure

Question 13

Treatment for subarachnoid hem?

Answer 13

Stop anticoagulants
Nimodipine
Initiate anti hypertensives (Beta blockers, Ca blocker)
AEDs if have seizures

Question 14

Bell’s palsy findings?

Answer 14

Ringing in the ears! FOOL!
Unilateral face paralysis
Ipsilateral lacrimation

Question 15

Possible cause of Bell’s?

Answer 15

Herpes zoster, HIV, syph, lyme and DM

Question 16

Course of Bell’s?

Answer 16

Acute onset residing in 3 weeks and resolving in 6 months

If symptoms > 4months horrid prognosis