Med Surg: Neurologic Flashcards
What is a transient Ischemia attack?
Visual defects: blurred vision, diplopia, amaurosis fugax, tunnel vision
Motor deficits: weakness (arm, hand or leg), ataxic
Sensory deficits: numbness (face, arm or hand), vertigo
Speech Deficits: Sphasia and dysarthria
What are the types of strokes?
Ischemia: occlusive
- Thrombotic: more than 1/2, clot, atherosclerosis in carotid or interacranial
- Embolic: clot broken off (heart), non-valve a-fib, HTN, prosthetic heart valve, antime plaque break off
Hemorrhagic: aneurysm, hypertension, arterio-venous malformation
What are the S&S of Thrombotic stroke?
daytime
slow onset
awake
HTN
speech defects
visual problems
confusion
normal CSF
no seizures
improvements over weeks
What are S&S of Embolic stroke?
daytime
sudden onset
awake
cardiac disease
paralysis
expressive aphasia
normal CSF
no seizures
reapid improvement
What are S&S of Hemorrhagic stroke?
daytime
sudden onset
stupor or coma
HTN
focal deficits
bloody CSF
usually seizures
variable duration
What are risk factors for stroke?
cerebral aneurysm
arteriovenous malformation
DM
obestiy
HTN
atherosclerosis
Hyperlipidemia
Hypercoagulability
atrial fibrillation
use of oral contraceptives
smoking cocaine use
What are diagnostic procedures for stroke?
CT without contrast
MRI
MRA
cerebran angiography
Lumbar puncture
Lab values: hgb, hct due to lact of O2 to the brain
What is health promotion for stroke?
History of meds, social history and medical
Onset and how the symptoms progressed
Determine severity of symptoms
Stroke assessment toolds
Cognitive changes
- Left hemisphere: language, math, analytic
- right hemisphere: visual, spatial awareness, proprioception
Sensory changes
- unilateral body neglect syndrome
- visual ability
What is the treatment for stroke?
Maintain perfusion, restore circulation, manage edema and ICP
“Golden Hour” door to needle <60 minutes
TPA IV 3 hours now 4.5 hours
TPA IA 6-12 hours
What are the medications for stroke?
Anticoagulants
Antiplatelets
Thrombolytics
Antiepileptics
Antihypertensives
What are stroke symptoms?
Sudden numbness or weaknes of the body, especially one side
Sudden vision changes in one or both eyes, or difficulty swallowing
Sudden, severe headache with unknown cause
Sudden problems with dizziness, walking or balance
Sudden confusion, difficulty speaking or understanding others
