Clinical Stroke

Question 1

two major stroke subtypes

Answer 1

• ischemic

- hemorrhagic

Question 2

putamenal hemorrhage

Answer 2

• located to the putamen

Question 3

• may have sudden onset with smooth preogression of deficit
• focal deficit
• headache
• nausea/vomiting
• decreased level of consciousness

Answer 3

intracerebral hemorrhage

Question 4

intracerebral hemorrhage tx.

Answer 4

no specific therapy

- Supportive; BP management

Question 5

CN III is close to which artery?

Answer 5

Posterior Communicating A.

Question 6

• sudden onset headache
• stiff neck
• photophobia
• nausea/ vomiting
• transient loss of consciousness

Answer 6

subarachnoid hemorrhage

Question 7

subarachnoid hemorrhage is the worst headache of my life?

Answer 7

Forget that term!

Question 8

subarachnoid hemorrhage will have a “ ____ bleed”

and lumbar puncture shows

Answer 8

sentinal bleed and shows red blood cells and xanthochromia

Question 9

major concerns of subarachnoid hemorrhage

Answer 9

• rebleeding
• vasospasm
• seizure
• increased intracranial pressure

Question 10

a tangle of abnormal vessels which form an aberrant communcation between arterial and venous systems

Answer 10

arteriovenous malformation (AVM)

Question 11

AVM tend to have thinned or thick walled vessels?

Answer 11

thin!!!!

Question 12

sings of AVM

Answer 12

• any focal deficits

- cranial bruits

Question 13

AVM symptoms

Answer 13

• subarachnoid hemorrhage
• intraparenchymal hemorrhage
• seizures
• headaches

Question 14

AVM tx.

Answer 14

obliteration of malformation by:

• surgical excision
• endovascular thrombosis
• radiation- including Gamma knife

Question 15

lipohyalinosis

Answer 15

small vessel disease

Question 16

common mechanism of cerebral ischemia

Answer 16

• embolism

- decreased perfusion through a fixed stenosis

Question 17

small vessel disease is associated with

Answer 17

HTN, DM and probs cholesterol

Question 18

lacune

Answer 18

small vessel disease

Question 19

not all small strokes are due to a small vessel disease

Answer 19

true

Question 20

what can be used to identify strokes?

Answer 20

• transcranial ultrasound
• carotid ultrasound
• angiogram

Question 21

medical managment for carotid artery stenosis

Answer 21

risk factor control
antiplatelet agents
HMG-CoA reductase inhibitor

Question 22

common cardiac condition associated with cerebral embolism

Answer 22

atrial fibrillation

Question 23

hypercoagulable states commonly associated with

Answer 23

cancer

Question 24

plumbing approach

Answer 24

revascularization

Question 25

neuroprotection

Answer 25

preventing damage from ischemic cascade

Question 26

magic hour

Answer 26

refers to that is the maximum time the patient to be seen by the doctors

Question 27

t-PA has any benefits for Ischemic stroke?

Answer 27

yass