Ch 1 - Stroke: Name the Lesion

Question 1

Where is the lesion

Answer 1

A - Optic Nerve

Question 2

Where is the lesion

Answer 2

B - Base of left optic nerve (Wilbrand’s knee)

Question 3

Where is the lesion

Answer 3

C - Optic Chiasm

Question 4

Where is the lesion

Answer 4

D - Optic tract

OR

G - Striate cortex

Question 5

Where is the lesion

Answer 5

E - Visual radiations (lateral portion)

Question 6

Where is the lesion

Answer 6

F - Visual radiations (medial portion)

Question 7

What is a stroke?

Answer 7

Rapidly developing cerebral function signs lasting >24 hours or leading to death with no cause other than vascular origin

Question 8

What is a transient ischemic attack?

Answer 8

Stroke sympoms <24 hours

Question 9

What are the non-modifiable risk factors of stroke

Answer 9

Age >55

Male>female

African America 2x>Caucasians>Asians

Family history of stroke

Question 10

What are modifiable risk factors of stroke?

Answer 10

HTN

Hx of TIA/Stroke

Heart dz (CHF, AFib, Valvular dz, CAD, PFO)

Diabetes

Cigarette smoking

Carotid Stenosis

ETOH abuse/cocaine use

High dose estrogens

Hypercoagable states

HLD, Obesity/sedentary lifestyle

Migraine HA

Sleep apnea

Question 11

Where are the “stoke belt” states?

Answer 11

Southeastern US

Question 12

Which cerebtral artery supplies the lower limb motor strip?

Answer 12

Anterior cerebral artery (ACA)

Question 13

Which cerebral artery supplies the upper limb motor strip?

Answer 13

Middle cerebral artery (MCA)

Question 14

What are the types of ischemic stroke?

Answer 14

Thrombolic

Embolic

Lacunar

Question 15

What are the types of hemorrhagic stroke?

Answer 15

Intracerebral (ICH): HTN

Subarachnoid (SAH): rupture aneurysm

Question 16

Characteristics of thombotic strokes

Answer 16

Usually occur at night

Intermittent progress of neuro deficits

Slowly progress over 24-48 hours

Neuro deficits depend on cerebral territory affected

Question 17

Characteristics of embolic strokes

Answer 17

Immediate onset of neuro deficits

Usually while patient awake

Siezures may occur at onset

MCC cardiac source (mural thrombi and platelet aggregate

Question 18

Causes of cardiac emboli

Answer 18

Afib

Rheumatic heart disease (mitral valve stenosis)

Post-MI

Vegetation on heart valves

Question 19

Characteristics of Lacunar strokes

Answer 19

Onset acute or gradual

Strong correlation with HTN

Small infarcts (Occlusive ateriolar or small artery dz)

Ofter pure motor or sensory synd

Absence of higher cortical function involvement