Hemorrhagic Strokes Flashcards
Charcot-bouchard aneurysm
Microaneurysms of small brain vessels due to htn, that can cause intracerebral hemorrhage
What is affected in pure motor hemiplegia
Lacunar stroke - posterior limb of IC, corona radiata, pons
Clinical presentation of AVM rupture
Hemorrhage, seizure, headache, neurological deficit
Eye deviation of ischemic vs hemorrhagic strokes
Ischemic = toward lesion Hemorrhagic = away from lesion
6 types of lacunar strokes
- Pure sensory
- Pure motor
- Sensorimotor
- Clumsy hand syndrome
- Hemichorea-hemiballismus
- Ataxia and leg paralysis
Type of aneurysm seen in SAH
Berry aneurysm/saccular aneurysm
Hemorrhage in putamen symptoms
Hemiplegia, vomiting, headache
What is affected in clumsy hand syndrome
Lacunar stroke - anterior limb of internal capsule
Most common location for saccular aneurysms
Anterior part of circle of willis at bifurcation of artery
Cerebellum hemorrhagic stroke sx
Coma, LOC, vomiting, HA, vertigo, ataxia, dysarthria, dysphasia, CN 6 palsy
Thalamus hemorrhagic stroke symptoms
Hemiplegia, c/l sensory deficits, aphasia/hemineglect, ocular sx
Peak age for rupture of aneurysm
50-60
What artery supplies posterior limb of internal capsule
Lenticular striate artery
What is sentinel headache
Sudden, intense and persistent headache preceding SAH
When is highest risk of mortality from SAH
First 24 hours - 25% mortality rate
Most common location for htnsive intracerebral hemorrhage
Putamen
Pons hemorrhagic stroke sx
Deep coma, total paralysis, decerebrate rigidity, death
What is affected in sensorimotor lacunar stroke
Junction of internal capsule and thalamus
What CN is commonly affected in SAH
CN 3
How big do aneurysms get before they’re at risk of rupture
10mm
What CN is affected in cerebellar hemorrhagic stroke
CN 6
What is hunt and hess scale
Scale for severity of nontraumatic SAH (1-5)
What is affected in hemichorea-hemiballismus
Lacunar stroke of head of caudate, thalamus, subthalamic nucleus
Large vs small AVM and risk of hemorrhage
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
Signs of CN3 problem
Deviation of eye to lateral side because of unopposed LR muscle.
Ptosis.
Mydriasis.
Paralysis of accommodation.
What is affected in pure sensory stroke
Lacunar - thalamus
What is used to treat vasospasm after SAH
Nimodipine (CCB)
