CVA and TIA

Question 1

What are the supply trains of blood to the brain?

Answer 1

• Internal Carotid Arteries (2)
• Vertebral - Basilar Arteries (2)
• Circle of Willis

Question 2

What do the internal carotid arteries supply?

Answer 2

Ipsilateral cerebral hemisphere

Question 3

What are the two major branches of the internal carotid arteries?

Answer 3

ACA - anterior cerebral artery

MCA - Middle cerebral artery

Question 4

What does the vertebral - basilar arteries supply?

Answer 4

Cerebellum and Brainstem

*Forms the PCA - Posterior Cerebral Artery

Question 5

What does the Circle of Willis connect?

Answer 5

Connects the Internal Carotid arteries with the basilar arteries

• PCA
• ACA
• MCA

Question 6

What is a stroke?

Answer 6

Acute neurological injury that occurs as the result of interrupted blood flow to the brain

Question 7

What are the two types of stroke?

Answer 7

Hemorrhagic

Ischemic

Question 8

What are the subtypes to Ischemic Stoke?

Answer 8

TIA

CVA

Question 9

What are the most common types of strokes?

Answer 9

Ischemic

Question 10

What is the 3rd leading medical cause of death?

Answer 10

Stroke

Question 11

Can the two types of stroke be distinguished bases solely on clinical criteria?

Answer 11

Nope

Question 12

What are risk factors for Stroke?

Answer 12

• HTN
• Atherosclerosis
• Age

Question 13

There’s 3 subtypes to Ischemic stroked; Thrombotic, Embolic, and Systemic Hypoperfusion. Explain these briefly…

Answer 13

• Thrombotic - blockage that forms
• Embolic - blockage due to embolis that breaks off from somewhere else
• Systemic - decreased systemic blood flow

Question 14

Difference between TIA and CVA?

Answer 14

Both are ischemic strokes, CVA involves infarction of CNS tissue.

***TIA can become a CVA

Question 15

How can you tell the difference between a TIA and CVA?

Answer 15

MRI

Question 16

Symptoms of stroke are sudden and involve focal neuro deficits. What is the Mnemonic to remember s/s of stroke?

Answer 16

F - Facial droop
A - Arm weakness
S - Stability
T - Talking
E - Eyes
R - React immediately and note time

Question 17

What are some risk factors of ischemic stroke? (Think of conditions that make cause thrombosis, embolisms, or hypoperfusion)

Answer 17

• Vascular disease
• MI
• Atrial/Ventricular Septal Defects
• DVT
• A Fib
• Atherosclerosis
• Clotting disorders

Question 18

What are the two subtypes to Hemorrhagic stroke?

Answer 18

• Intracerebral - straight bleed to the brain tissue

* Subarachnoid hemorrhage - bleed in subarachnoid space

Question 19

S/S of ICH?

Answer 19

• Gradual onset as blood pools

* HA, Vomiting, Decreased LOC

Question 20

S/S SAH?

Answer 20

• Thunderclap HA or worst HA ever

* Very Quick onset

Question 21

What are some risk factors of Hemorrhagic strokes?

Answer 21

• HTN
• Trauma
• Aneurysms
• Bleeding disorders
• Drug use

Question 22

What are signs of emboli?

Answer 22

DVT

Carotid Bruits

Question 23

What level should O2 sats be maintained?

Answer 23

> 94%

Question 24

Treatment for Hemorrhagic stroke?

Answer 24

• O2

* Elevate head 30 degrees

Question 25

When can you treat hemorrhagic stroke with a antihypertensive (beta blocker)?

Answer 25

If systolic >220 or diastolic > 120

Question 26

Why would you not try to lower blood pressure if less than 220/120?

Answer 26

May be the only thing keeping them adequately perfused

Question 27

labs and imaging for hemorrhagic stroke?

Answer 27

Labs

• CBC
• Finger glucose

Image

• non-contrast CT
• MRI

Question 28

According to MANMED 15-106, what types of cerebral diseases are disqualifying?

Answer 28

• Strokes (Ischemic and hemorrhagic)

* Vascular malformations