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neuropath 1 > Class 6 - Strokes > Flashcards

Class 6 - Strokes Flashcards

1
Q

What is a stroke?

A

sudden death of brain cells d/t lack of oxygen

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2
Q

Strokes are the leading cause of…

A

longterm disability

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3
Q

Strokes can be caused by either:

A

hemorrhage (aneurysm) or blockage of blood flow/ischemia

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4
Q

TIA produce stroke-like symptoms BUT…

A

do not leave lasting damage

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5
Q

What is the GREATEST risk factor for strokes?

A

age (chance doubles each decade after age 55)

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6
Q

What does the ABCD stand for in looking at the chances of stroke progression?

A

A - age
B - blood pressure (over 140/90)
C - clinical features (weakness on one side of body, speech trouble)
D - duration of symptoms

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7
Q

Medical complications occur in up to what percentage of stroke survivors?

A

85%

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8
Q

What is the most common medical complication of strokes?

A

having a fall in the first 6 months

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9
Q

85% of strokes are of what type?

A

ischemic

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10
Q

15% of strokes are of what type?

A

hemorrhagic

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11
Q

Ischemic strokes lead to cerebral infarctions, which may have one of two causes:

A

atherosclerotic

cardiogenic emboli

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12
Q

The most common source of cerebral emboli is…

A

the heart

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13
Q

Define “ischemic penumbra”

A

the area surrounding infarction tissue that receives sufficient blood from collateral vessels

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14
Q

A patient having a stroke comes in with contralateral hemiplegia and hemianesthesia. Which cerebral artery is likely affected?

A

the middle cerebral artery

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15
Q

What would be observed in Wernicke’s aphasia?

A

inability to comprehend written and oral language, jargon speech

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16
Q

In middle cerebral artery syndrome, if the dominant hemisphere is affected, what will be seen?

A

global aphasia

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17
Q

Which cerebral arterial syndrome sees the least amount of dysfunction?

A

anterior cerebral artery

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18
Q

Which cerebral arterial syndrome would appear with contralateral hemiparesis and sensory loss?

A

anterior cerebral artery syndrome

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19
Q

Define ‘abulia’

A

extreme apathy, delays in verbal and motor response

20
Q

What are the three branches of the posterior cerebral artery?

A

cerebral branch
occipital branch
temporal branch

21
Q

Occlusion of the cerebral branch of the posterior cerebral artery will lead to…

A

thalamic syndrome (abnormal sensation of pain, temperature, proprioception, touch…)

22
Q

Occlusion of the occipital branch of the posterior cerebral artery will result in…

A

hemianopia and/or cortical blindness

23
Q

What is cortical blindness?

A

blindness due to something occurring with the brain rather than the eye

24
Q

What is hemianopia?

A

loss of half your field of vision (opposite side as to where brain lesion is)

25
Q

Occlusion of the temporal branch of the posterior cerebral artery would result in…

A

acute memory disturbances, visual hallucinations

26
Q

What are typical symptoms of internal carotid artery syndrome?

A

contralateral weakness or sensory disturbance

ipsilateral blindness

27
Q

Primary ICH is associated with…

A

high BP

aging

28
Q

Secondary ICH is associated with…

A

trauma, impaired coagulation, toxin exposure

29
Q

The incidence of intracerebral hemorrhage increases dramatically after age…

A

65

30
Q

ICH are more common in….

A

men, african-americans, and asians

31
Q

The risk of ICH is increased with…

A

longterm use of anticoagulants
alcohol abuse
age (after 80 is 25x higher)

32
Q

If an ICH condition is stabilized, what can happen to the hematoma?

A

reabsorption

33
Q

What is the biggest predictor of mortality with ICH?

A

the size of the hemorrhage

34
Q

What is an epidural hematoma?

A

bleeding between the dura and the skull

35
Q

What is the treatment for epidural hematoma?

A

surgery

36
Q

This hemorrhage can be spontaneous, is often seen in normotensive people, and causes a sudden, severe headache. What is it?

A

subarachnoid hemorrhage

37
Q

Who is at the highest risk for a SAH?

A

women over age 70

38
Q

40% of people who end up with a SAH present with what?

A

a sentinel headache from a minor aneurysm leak that precedes the hemorrhage by days or weeks

39
Q

This type of headache can occur in any location, may be mild, may resolve spontaneously, and may resolve with analgesics. What is it?

A

sentinel headache of a subarachnoid hemorrhage

40
Q

What are the main associated symptoms with a SAH/SAH headache?

A

nausea, vomiting
syncope
neck pain

41
Q

Up to 38% of people with SAH are misdiagnosed at first, usually with one of 3 conditions:

A

viral meningitis
migraine
headache of unknown cause

42
Q

How are SAH diagnosed?

A

CT scan
lumbar puncture
angiography

43
Q

The prognosis of SAH is good IF…

A

the hematoma is less than 3cm

44
Q

What is the second cause of death in the world?

A

strokes

45
Q

Ischemic strokes are treated with…

A

antihypertensives
thrombolytic/antithrombic medications
anticoagulants

46
Q

With strokes, neurological symptoms have a sudden onset in ?% of cases

A

30%

neuropath 1 (11 decks)

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