Cerebrovascular symptoms and treatments Flashcards
Transient Ischemic Attack (TIA)?
- Duration of symptoms
- When a patient’s symptoms resolve in <24 hours
- Usually sudden and brief
- Last 10-15 mins
- often multiple in nature
TIA’s affect what?
- TIA’s affect the side of the body opposite its physical location in the brain with the exception of amaurosis fugax (loss of vision in one eye)
- Patients who present with multiple TIA’s in a short period of time are at a much higher risk for an impending stroke
Reversible ischemic neuorological deficity (RIND)?
Symptoms lasting >24 hours but completely resolve thereafter
Cerebral vascular accident (CVA)?
- Major stroke
- symptoms that do not resolve and leave the patient with a permanent deficit
maurosis fugax?
- A degree of blindness affecting one eye which is usually described by the patient as “like a shade being pulled over one eye”
- The blindness may affect all or only a portion of the patient’s visual field or it may simply be “blurred vision”
Syncope?
- Episodes of blacking out
Aphasia?
Loss of speach
Symptoms of potential stroke? (6)
- Amaurosis fugax
- synscope
- dizziness
- numbness
- altered speech
- hemiparesis
- headache
Hemiparesis?
Unilateral weakness of a limb or limbs on one side of the body
amaurosis fugax usually occurs from what vessel?
ICA
What is the most common cause of stroke?
infarction of the middle cerebral artery (MCA)
Affected artery MCA signs and symptoms?
Dysphasia or aphasia Contralateral hemiparesis or hemiplegia more severe in the face and upper extremity Confusion Behavioral changes Agitated delirium
dysphasia?
swallowing difficulties
Affected artery: ICA signs and symptoms?
Contralateral weakness Numbness or paralysis Ipsilateral amaurosis fugax Aphasia Bruit Occasional alteration in level of consciousness
Affected artery: ACA S/S?
Contralateral hemiparesis, especially of lower extremity
Incontinence
Loss of coordination
Impaired motor and sensory functions
Affected artery: PCA s/s?
Dyslexia
Coma without paralysis
Affected arteries: vertebrobasilar s/s?
Facial numbness Diplopia (double vision) Vertigo Dysphagia Amnesia Ataxia (loss of full control of bodily movements)
Carotid: anterior circulation s/s?
Unilateral motor and sensory deficits Paresthesia-tingling or numbness on one side Dysphasia and or aphasia Monocular disturbances Behavioral abnormalities
Vertebrovascular- posterior circulation s/s?
Bilateral motor and sensory deficits
Vertigo (a spinning sensation)
Ataxia (unsteadiness-muscular incoordination)
Bilateral visual field defects including diplopia
Bilateral paresthesia
Drop attack-falling to the ground without other symptoms or loss of consciousness
Nonlocalizing symptoms?
Dizziness-lightheadedness
Syncope-a transient loss of conciousness
Headache
Confusion
Endarterectomy?
- who can get the procedure?
- most symptomatic patients with a stenosis >70% diameter reduction are treated surgically
- Some surgeons are performing endarterectomies in patients who are asymptomatic with a stenosis of >60%
Non-surgical methods for treating carotid atherosclerosis?
- balloon angioplasty and atherectomy
- greater risk of acute embolization secondary to these procedures
Medical therapy in patients with carotid disease is offered in the form of?
- Daily aspirin (81mg)
- in patients with mild to moderate levels of stenosis and no history of hypertension
Anticoagulants and platelet inhibitors may be administered to patients with?
Occasional TIA’s
Example of a platelet inhibitor?
Clopidogrel (Plavix)
