Neuro 1 Flashcards
ischemic stroke - clinical pres
5
- lateralized weakness
- +/- numbness of face or extremity
- aphasia
- dysarthria
- hemianopia
hemorrhagic stroke - clinical pres
4
- sudden onset of severe HA
- NV
- elevated BP
- neuro deficits
consider posterior circulation stroke if patient presents with
3
- dizziness
- NV
- ataxia
stroke - assess for patients what
LNW time
stroke - tPA window
3-4.5 hours of LNW
stroke - assess for what additional history findings and symptom
3 (sign, use, dx)
- fever
- IV drug use
- infective endocarditis
stroke - PE
1
comprehensive neuro exam
stroke - img/testing
2
do not delay transfer in favor of imaging or testing
POC glucose
stroke - DD
6
- vertigo
- migraine
- seizures
- electrolyte abnormalities
- medication or drug toxicity
- infection
stroke - tx and disposition
3 (obtain, call, do not)
- obtain hx and perform exam rapidly
- call EMS to transfer to nearest stroke center
- do not lower BP in OP setting
tension headache - clinical pres
6
- mild to moderate intensity
- non pulsating
- non exertional
- “pressure” or “tightening”
- bilateral
- neck pain
cluster headache - clinical pres
8
- unilateral
- severe HA
- may radiate to jaw or neck
- concomitant lacrimation
- recurring
- typically in young adult males
- typically resolves in about 2 hours
- no aura or NA
migraine headache - clinical pres
10
- often unilateral
- nausea
- photosensitivity/noise sensitivity
- pulsatile in nature
- exacerbated by physical activity
- prodrome/aura
- flashing lights
- depression/anhedonia
- fatigue
- irritability
headache - non pulsating, bilateral, pressure, neck pain
tension
headache - unilateral, radiates, lacrimation
cluster
headache - unilateral, photosensitivity, irritable
migraine
tension HA - PE findings
2
- normal neuro exam
- neck tenderness/spasm
cluster HA - PE findings
4
- unilateral lacrimation and injection
- nasal congestion
- pallor or flushing may be present
- restlessness/pacing
migraine HA - PE findings
1
neuro exam normal although some may cause neurological sx
headache - img/testing
none usually if presentation is consistent w/ prior HAs
headache - can’t miss DD
6
- subarachnoid hemorrhage - worst HA of your life, sudden onset
- stroke - new neuro sx
- meningitis - fever and nuchal rigidity
- cavernous sinus thrombosis (severe HA, bulging eyes, vision changes, drooping eyelid, fever and more - recent sinusitis or surgery)
- giant cell arteritis - older patients, usually female, jaw claudication (jaw pain or fatigue when chewing) and visual symptoms
- malignancy - new neuro sx, new onset sz
general HA/migraine tx
1 first line always
- analgesics
HA - NSAIDs should be use in what frequency a month
14 days of less a month
migraine tx
1st line - NSAIDs then Acetaminophen
If not helping - triptans I.e eletriptan 40 mg PO. If symptoms persist or return, may repeat dose after ≥2 hours. Maximum: 40 mg/dose; 80 mg per 24 hours
