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B&B 2 > Cerebrovascular disorders > Flashcards

Cerebrovascular disorders Flashcards

1
Q

Stroke/ TIA- Sx

A
  • Sudden onset of weakness in face, arm, leg
  • Unilateral
  • Numbness
  • loss of vision, double vision
  • Trouble talking (language problem), slurred speech
  • True vertigo
  • Incoordination on one side
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2
Q

Cardioembolic stroke- Eti

A
  • 25-30% ischemic stroke
  • Afib and post MI- begins in heart
  • Can go to any vessel
  • Anterior and middle cerebral most common
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3
Q

Lacunar stroke- Eti

A
  • 25% ischemic stroke
  • Small arteries, small stroke
  • DM and HTN
  • Better prognosis
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4
Q

Transient ischemic attack- Eti

A
  • Highest risk of progression to stroke in 1 month
  • Embolization commonly
  • Afib, heart dz, MI
  • Hx of vascular disease
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5
Q

Transient ischemic attack- Sx

A
  • Acute, focal neurologic deficit
  • Resolves within 24 hours
  • Weakness on contralateral arm
  • Numbness and paresthesia
  • Transient monocular blindness (Amaurosis fugax)
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6
Q

Transient ischemic attack- Dx

A
  • CT or MRI scan within 24 hrs

- Asses for underlying cause

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7
Q

Transient ischemic attack- Tx

A
  • Anticoagulants
  • Aspirin
  • Angioplasty or stenting
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8
Q

Lacunar infarct- Tx

A

Aspirin

- Tx chronic dz

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9
Q

Lacunar infarct- Dx

A

-MRI

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10
Q

Carotid artery obstruction- Anterior- Sx

A
  • Anterior: Sensory loss in contralateral leg
  • Arm weakness
  • Contralateral grasp reflex
  • Paratonic rigidity
  • Confusion
  • Behavioral and memory disturbance
  • Incontinence
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11
Q

Carotid artery obstruction- Middle- Sx

A
  • Contralateral hemiplegia
  • Hemisensory memory loss
  • Homoymous hemianopia
  • Eyes deviated to side of lesion
  • Drowsiness, stupor and coma
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12
Q

Vertebrobasilar obstruction- Posterior- Sx

A
  • Spontaneous pain
  • Macular sparing hemionymous hemiopia
  • Mild hemiparesis
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13
Q

Vertebrobasilar obstruction- Vertebral- Sx

A
  • Clinically silent
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14
Q

Vertebrobasilar obstruction- Basilar- Sx

A

Coma with pinpoint pupils

  • Flaccid quadriplegia
  • Sensory loss
  • Cranial nerve abn
  • Diplopia,
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15
Q

Ischemic stroke- Dx

A
  • CT or MRI

- Determine cause

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16
Q

Ischemic stroke- Tx

A
  • IV throbolytics before 4.5 hrs
  • Aspirin if tPA contraindicated
  • Manage systemic sx
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17
Q

Intracerebral hemorrhage- Eti

A
  • Spontaneous, non truamatic
  • No vascular anomolies
  • HTN- microaneuryisms
  • Advanced age, male
18
Q

Intracerebral hemorrhage- Sx

A
  • LOC
  • Vomiting, HA
  • Rapidly evolving neuro deficit- hemiplegia
19
Q

Intracerebral hemorrhage- Dx

A

CT scan

20
Q

Intracerebral hemorrhage- Tx

A
  • Supportive tx

- Ventricular drainage, hemostasis

21
Q

Spontaneous subarachnoid hemorrhage- Eti

A
  • 5-10% strokes
  • Trauma
  • Old, female, ethnic, smoker with high alcohol consumption
22
Q

Spontaneous subarachnoid hemorrhage- Sx

A
  • Sudden, severe HA
  • N/V
  • Signs of meningeal irritation, nuchal rigidity
  • Transient LOC to coma to death
23
Q

Spontaneous subarachnoid hemorrhage- Dx

A
  • CT
  • CSF exam
  • Cerebral arteriography
24
Q

Spontaneous subarachnoid hemorrhage- Tx

A
  • Prevent further hemorrhage

- Greatest within first days

25
Q

Intracranial aneurysm- Eti

A
  • Polycystic disease, coarctation of aorta
  • Smoking, HTN, hypercholesterol
  • Circle of willis
  • Old, female, ethnic, smoker with high alcohol consumption
26
Q

Intracranial aneurysm- Sx

A
  • Asymptomatic, nonspecific until rupture
  • Same sx as subarachnoid:
  • Sudden, severe HA
  • N/V
  • Signs of meningeal irritation, nuchal rigidity
  • Transient LOC to coma to death
27
Q

Intracranial aneurysm- Dx

A
  • Angiography
28
Q

Intracranial aneurysm-Tx

A

Prevent hemorrhage- surgically or endovascularaly

29
Q

Arteriovenous malformations- Eti

A
  • Congenital vascular malformation
  • Assoc with arterial aneurysm
  • Supratentoral most common
  • Sx manifest before age 40
30
Q

Arteriovenous malformations- Sx

A
  • Hemorrhage
  • Recurrent seizure
  • HA
  • Focal neuro deficiencies depending on brain region affected
    Cranial bruit- over ipsilateral eye
31
Q

Arteriovenous malformations- Dx

A
  • CT

- Arteriography

32
Q

Arteriovenous malformations- Tx

A
  • Surgery to prevent further hemorrhage
33
Q

Subclavian steal syndrome- Eti

A
  • Subclavian artery stenosis
34
Q

Subclavian steal syndrome- Sx

A
  • Unequal upper extremity BP
  • Vertigo and syncope
  • Ulcerated or gangrenous fingers
35
Q

Subclavian steal syndrome- Tx

A

Revascularization

36
Q

Amaurosis fugax- Eti

A
  • TIA of retina
  • Emboli stuck in retinal vessel
  • HTN, hypercholesterol
37
Q

Amaurosis fugax- Sx

A
  • Curtain of blindness, monocular
  • Whitened, edematous retina
  • Cherry red fovea
38
Q

Pseudotumor cerebri- Eti

A
  • Lots of causes: thrombosis, otitis media, mastoiditis, pulm dz, lupus…
  • Benign intracranial htn
  • Overweight women 20-44
39
Q

Pseudotumor cerebri- Sx

A
  • HA, diplopia
  • Enlargement of blind spots
  • Papilledema
  • Abducens nerve dysfunction
40
Q

Pseudotumor cerebri- Dx

A
  • Lumbar puncture
  • CT- RO lesion
  • MR venography
41
Q

Pseudotumor cerebri- Tx

A
  • Acetaxolamide- reduction of CSF

- Tx underlying cause

B&B 2 (9 decks)

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