Hemorrhagic Strokes

Question 1

Charcot-bouchard aneurysm

Answer 1

Microaneurysms of small brain vessels due to htn, that can cause intracerebral hemorrhage

Question 2

What is affected in pure motor hemiplegia

Answer 2

Lacunar stroke - posterior limb of IC, corona radiata, pons

Question 3

Clinical presentation of AVM rupture

Answer 3

Hemorrhage, seizure, headache, neurological deficit

Question 4

Eye deviation of ischemic vs hemorrhagic strokes

Answer 4

Ischemic = toward lesion
Hemorrhagic = away from lesion

Question 5

6 types of lacunar strokes

Answer 5

1. Pure sensory
2. Pure motor
3. Sensorimotor
4. Clumsy hand syndrome
5. Hemichorea-hemiballismus
6. Ataxia and leg paralysis

Question 6

Type of aneurysm seen in SAH

Answer 6

Berry aneurysm/saccular aneurysm

Question 7

Hemorrhage in putamen symptoms

Answer 7

Hemiplegia, vomiting, headache

Question 8

What is affected in clumsy hand syndrome

Answer 8

Lacunar stroke - anterior limb of internal capsule

Question 9

Most common location for saccular aneurysms

Answer 9

Anterior part of circle of willis at bifurcation of artery

Question 10

Cerebellum hemorrhagic stroke sx

Answer 10

Coma, LOC, vomiting, HA, vertigo, ataxia, dysarthria, dysphasia, CN 6 palsy

Question 11

Thalamus hemorrhagic stroke symptoms

Answer 11

Hemiplegia, c/l sensory deficits, aphasia/hemineglect, ocular sx

Question 12

Peak age for rupture of aneurysm

Answer 12

50-60

Question 13

What artery supplies posterior limb of internal capsule

Answer 13

Lenticular striate artery

Question 14

What is sentinel headache

Answer 14

Sudden, intense and persistent headache preceding SAH

Question 15

When is highest risk of mortality from SAH

Answer 15

First 24 hours - 25% mortality rate

Question 16

Most common location for htnsive intracerebral hemorrhage

Answer 16

Putamen

Question 17

Pons hemorrhagic stroke sx

Answer 17

Deep coma, total paralysis, decerebrate rigidity, death

Question 18

What is affected in sensorimotor lacunar stroke

Answer 18

Junction of internal capsule and thalamus

Question 19

What CN is commonly affected in SAH

Answer 19

CN 3

Question 20

How big do aneurysms get before they’re at risk of rupture

Answer 20

10mm

Question 21

What CN is affected in cerebellar hemorrhagic stroke

Answer 21

CN 6

Question 22

What is hunt and hess scale

Answer 22

Scale for severity of nontraumatic SAH (1-5)

Question 23

What is affected in hemichorea-hemiballismus

Answer 23

Lacunar stroke of head of caudate, thalamus, subthalamic nucleus

Question 24

Large vs small AVM and risk of hemorrhage

Answer 24

More common in small AVM because of increased resistance and pressure. Large AVM has low pressure and needs a distal blood clot to increase pressure to cause hemorrhage

Question 25

Signs of CN3 problem

Answer 25

Deviation of eye to lateral side because of unopposed LR muscle.
Ptosis.
Mydriasis.
Paralysis of accommodation.

Question 26

What is affected in pure sensory stroke

Answer 26

Lacunar - thalamus

Question 27

What is used to treat vasospasm after SAH

Answer 27

Nimodipine (CCB)