Class 6 - Strokes

Question 1

What is a stroke?

Answer 1

sudden death of brain cells d/t lack of oxygen

Question 2

Strokes are the leading cause of…

Answer 2

longterm disability

Question 3

Strokes can be caused by either:

Answer 3

hemorrhage (aneurysm) or blockage of blood flow/ischemia

Question 4

TIA produce stroke-like symptoms BUT…

Answer 4

do not leave lasting damage

Question 5

What is the GREATEST risk factor for strokes?

Answer 5

age (chance doubles each decade after age 55)

Question 6

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

Answer 6

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

Question 7

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

Answer 7

85%

Question 8

What is the most common medical complication of strokes?

Answer 8

having a fall in the first 6 months

Question 9

85% of strokes are of what type?

Answer 9

ischemic

Question 10

15% of strokes are of what type?

Answer 10

hemorrhagic

Question 11

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

Answer 11

atherosclerotic

cardiogenic emboli

Question 12

The most common source of cerebral emboli is…

Answer 12

the heart

Question 13

Define “ischemic penumbra”

Answer 13

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

Question 14

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

Answer 14

the middle cerebral artery

Question 15

What would be observed in Wernicke’s aphasia?

Answer 15

inability to comprehend written and oral language, jargon speech

Question 16

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

Answer 16

global aphasia

Question 17

Which cerebral arterial syndrome sees the least amount of dysfunction?

Answer 17

anterior cerebral artery

Question 18

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

Answer 18

anterior cerebral artery syndrome

Question 19

Define ‘abulia’

Answer 19

extreme apathy, delays in verbal and motor response

Question 20

What are the three branches of the posterior cerebral artery?

Answer 20

cerebral branch
occipital branch
temporal branch

Question 21

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

Answer 21

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

Question 22

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

Answer 22

hemianopia and/or cortical blindness

Question 23

What is cortical blindness?

Answer 23

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

Question 24

What is hemianopia?

Answer 24

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

Question 25

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

Answer 25

acute memory disturbances, visual hallucinations

Question 26

What are typical symptoms of internal carotid artery syndrome?

Answer 26

contralateral weakness or sensory disturbance | ipsilateral blindness

Question 27

Primary ICH is associated with...

Answer 27

high BP | aging

Question 28

Secondary ICH is associated with...

Answer 28

trauma, impaired coagulation, toxin exposure

Question 29

The incidence of intracerebral hemorrhage increases dramatically after age...

Answer 29

65

Question 30

ICH are more common in....

Answer 30

men, african-americans, and asians

Question 31

The risk of ICH is increased with...

Answer 31

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

Question 32

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

Answer 32

reabsorption

Question 33

What is the biggest predictor of mortality with ICH?

Answer 33

the size of the hemorrhage

Question 34

What is an epidural hematoma?

Answer 34

bleeding between the dura and the skull

Question 35

What is the treatment for epidural hematoma?

Answer 35

surgery

Question 36

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

Answer 36

subarachnoid hemorrhage

Question 37

Who is at the highest risk for a SAH?

Answer 37

women over age 70

Question 38

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

Answer 38

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

Question 39

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

Answer 39

sentinel headache of a subarachnoid hemorrhage

Question 40

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

Answer 40

nausea, vomiting syncope neck pain

Question 41

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

Answer 41

viral meningitis migraine headache of unknown cause

Question 42

How are SAH diagnosed?

Answer 42

CT scan lumbar puncture angiography

Question 43

The prognosis of SAH is good IF...

Answer 43

the hematoma is less than 3cm

Question 44

What is the second cause of death in the world?

Answer 44

strokes

Question 45

Ischemic strokes are treated with...

Answer 45

antihypertensives thrombolytic/antithrombic medications anticoagulants

Question 46

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

Answer 46

30%