Ischemic and hemorrhagic strokes

Question 1

most common cause of subarachnoid hemorrhage?: where? associated with other dz?

Answer 1

rupture of berry aneurysm. Anterior circle of willis (esp branch points of ant comm artery). Marfans and ADPKD

Question 2

Charcot-buchard microaneurysm

Answer 2

affects small vessels (esp in basal ganglia), associated with chronic HTN. Can result in lacunar strokes

Question 3

TIA

Answer 3

reversible, focal, <1hr, no acute infarction (-MRI)

Question 4

cerebral perfusion driven mainly by?

Answer 4

Pco2. Po2 only in severe hypoxia

Question 5

why do pts with cerebral ischemia lose their ability to autoregulate

Answer 5

the vessesls are maximally dilated so flow depends entirely on MAP

Question 6

Ischemic penumbra

Answer 6

area of brain that is ultimately going to infarct. 2 million neurons/min.

Question 7

how do we save the penumbra (ischemic stroke)

Answer 7

IV tPA, catheter based recanalization

Question 8

single deep stroke on imaging. Stroke in multiple distributions

Answer 8

lacunar. Cardioembolic.

Question 9

treatment for most ischemic stroke mechanisms? exception

Answer 9

antiplatelets. Cardioembolic from Afib treated with warfarin

Question 10

most common sites of spontaneous intracrainal hemorrhage

Answer 10

Putamen>Lobar>thalamic>cerebellar>pontine