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SSP > Chapter 8. Post Stroke Complication > Flashcards

Chapter 8. Post Stroke Complication Flashcards

1
Q

This is classically attributed to thalamic stroke

A

Central post stroke pain

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2
Q

First line of treatment of Central post stroke pain

A

Amitryptiline

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3
Q

What is the drug of choice in elderly with Central post stroke pain

A

Nortriptyline

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4
Q

What are the non pharmacologic management for Central post stroke pain

A

rTMS and vestibular caloric stimulation

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5
Q

What is the mobilization technique for Hemiplegic Shoulder Pain Syndrome

A

ER and abduction

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6
Q

What should be avoided in Hemiplegic Shoulder Pain Syndrome

A

Overhead pulley

Passive movement beyond 90degrees flexion and abduction

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7
Q

What are the pharmacologic treatment for CRPS pain

A

Pamidronate
Alendronate
Clodronate

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8
Q

Defined as early onset post stroke seizure

A

within 7 days

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9
Q

Late onset seizure usually occurs during

A

beyond 7 days

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10
Q

What is the explanation for early onset seizure

A

celullar biochemical dysfunction

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11
Q

What is the explanation of late onset seizure

A

“true post stroke seizure”

due to gliosis and development of meningocerebral cicatrix

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12
Q

What type of stroke will seizure be likely its manifestation

A

ICH

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13
Q 
Rate of post stroke seizure in the following stroke:
Multiple stroke \_\_
ICH \_\_\_
SAH \_\_\_
Unspecified hemorrhage \_\_\_
Ischemia \_\_\_
A 
Multiple stroke 7.7%
ICH 4.3%
SAH 4.2%
Unspecified hemorrhage 2.5%
Ischemia 1.6%
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14
Q

What is the outcome for early onset seizure

A

High incidence of status epilepticus and in-hospital mortality

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15
Q

What is the recurrence of late onset seizure

A

50% 5 year period recurrence

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16
Q

This is the most important and common neuropsychiatric complication affecting post-stroke

A

Post stroke depression

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17
Q

The incidence of post stroke depression

A

52%in 5 years

18
Q

The prevalence of post stroke depression

A

29%

19
Q

What are the sensitive predictor of post stroke depression

A

Depressed mood
Decreased appetite
Crying

20
Q

Prophylaxis using antidepressant is associated with

A

reduction of incidence of post stroke depression

21
Q

What medication is associated with maximum motor recovery in depressed patient

A

Fluoxetine

22
Q

Incidence of post-stroke demetia

A

7%

23
Q

Prevalence of post-stroke dementia

A

30%

24
Q

How to assess vascular dementia

A

test for executive function
Trail making test
CDT

25
Q

BP lowering is associated with what effect in cognitive decline

A

improve 3-4 points in MMSE

26
Q

Distribution of type of stroke in SIY

A

50% infarct
30% SAH
20% ICH

27
Q

What is the most common symptoms associated with missed diagnosis of stroke

A

Dizziness

28
Q

Hemorrhagic stroke in SIY are associated with

A

35% Hypocholesterol
20% Tobacco
13% hypertension
10% alcohol use

29
Q

Most common drug implicated to ICH in SIY

A

phenylpropanolamine

30
Q

Cavernous angioma is located in

A

Brainstem

31
Q

Drug of choice for PFO

A

ASA

32
Q

When is inferior vena cava filter indicated in PFO

A

When there is stroke/TIA despite anticoagulation and antiplatelet

33
Q

What is contraindicated in patients with migrain with aura

A

Triptans and ergots

34
Q

What is the lifestyle modification in patients with Migrane with Aura

A

Smoker cessation

35
Q

What is the recommended OCP if the patient insist to use one

A

Progestin and should be stop when there is occurrence of stroke

36
Q

Recommendation for hypercoagulable state in SIY

A
  1. initiate anticoagulation

2. if anticoagulation is contraindicated use antiplatelet

37
Q

Recommendation for APAS

A
  1. APAS with alternative explanation for ischemic event is not recommended
  2. If (+) APA but did not fulfill the APS criteria: antiplatelet
  3. If meet APS criteria: anticoagulation but may use antiplatelet if contraindicated to anticoagulation
38
Q

What are the recommendation for sicle cell disease

A
  1. Chronic blood transfusion to decrease hgb S to < 30% of total hgb
  2. Stroke with SCD and BT is not available: may give hydroxyurea
39
Q

In Helsinski Young Stroke Registry:

Cumulative risk at 1 month, 1 years and 5 years

A

1 month: 2.7%
1 years: 4.7%
5 years: 10.7%

40
Q

In Helsinski Young Stroke Registry:

5 year recurrence rate

A

11.5%

41
Q

In Helsinski Young Stroke Registry:

Epilepsy rate

A

10.5%

SSP (7 decks)

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