Neuro 1 pt7

Question 1

Spine’s Arterial Supply is from the Vertebrals and branches of the Thoracic & Abd aorta called ___ arteries.

Answer 1

Radicular arteries

Question 2

Stroke mgmt

Answer 2

NPO, resolving any issues regarding carotid atheroclerosis, or A Fib (as these are the 2 most common causes)

Question 3

___: you discovered someone had a stroke overnight. It could have happened in the last 10 hours.

Answer 3

Wake Up Stroke

Question 4

NIH Stroke Score has how many questions?

What’s the professor’s beef with this?

Answer 4

11 questions. Not enough questions about speech.

Question 5

The main sx of Carotid dissection is: (3)

Answer 5

syncope, hemiparesis, or coma

Question 6

Triad of Horner Syndrome

Answer 6

ptosis
miosis
anhydrosis

Question 7

ptosis, miosis, and anhydrosis are the key triad to diagonose:___ aka ___

Answer 7

Horner Syndrome

oculosympathetic palsy

Question 8

__ is caused by an abnormality or lesion to the sympathetic chain. The congenital variety is most commonly the result of birth trauma. Acquired cases may occur in children who have had cardiothoracic surgery, trauma, or brainstem vascular malformation. Most worrisome is a Horner syndrome caused by neuroblastoma of the sympathetic chain in the apical lung region

Answer 8

Horner Syndrome

Question 9

Horner Syndrome is caused by an abnormality of lesion in the ____

Answer 9

Sympathetic chain.

Question 10

With Horner Syndrome, The congenital variety is most commonly the result of ___

Answer 10

birth trauma

Question 11

Acquired cases of Horner Syndrome may occur in children who have had (3)

Answer 11

cardiothoracic surgery, trauma, or brainstem vascular malformation

Question 12

Most worrisome is a Horner syndrome caused by ___ of the sympathetic chain in the apical lung region

Answer 12

Neuroblastoma

Question 13

____ is a process of progressive demyelination and disintegration of distal axonal segment following neuronal damage

Answer 13

Wallerian degeneration

Question 14

What can cause Wallerian degeneration? (5)

Answer 14

cerebral infarction, hemorrhage, trauma, necrosis, and focal demyelination.

Question 15

10 groups that get aneurysms

Answer 15

Smokers
HTN
Minority are genetic(Marfan, Ehers-Danlos, Osler-Weber-Rendu, Klippel-Trenaunay-Weber)
Pts. with polycystic kidney dz.
Cocaine users
fibromuscular dysplasia
Moyamoya dz
Cerebral AVM
SLE
granulomatous angiitis

Question 16

incidental aneurysms <__ are not likely to rupture

Answer 16

< 7mm

Question 17

*Most common cause of sub arachnoid hemorrhage

Answer 17

Trauma

Question 18

The initial bleed of a SAH is called:

Answer 18

sentinel hemorrhage

Question 19

Top 3 locations of aneurysms (in circle of willis)

Answer 19

30% Anterior Communicating Artery
25% Posterior Communicating Artery
20% Middle Cerebral Artery

Question 20

Imaging for SAH.
Why is __ better than __?
If this imaging test doesn’t confirm the SAH, what else can you do?

Answer 20

A CT scan (preferably with a CT angiography) should be performed immediately to confirm that hemorrhage has occurred and to search for clues regarding its source.

It is preferable to MRI because it is faster and more sensitive in detecting hemorrhage in the first 24 hours.

CT findings sometimes are normal in patients with suspected hemorrhage, and the cerebrospinal fluid must then be examined for the presence of blood or xanthochromia before the possibility of subarachnoid hemorrhage is discounted.

Question 21

Most common CT of aneurysmal SAH looks like:

Answer 21

There is a star shape of white, where blood has spilled into the brain.

Question 22

____ is the occurrence of a vitreous hemorrhage of the human eye in association with subarachnoid hemorrhage

Answer 22

Terson’s syndrome

Question 23

Who knows what the mechanism for ocular hemorrhage (of Terson’s Syndrome/SAH) is?

Answer 23

The increased ICP affects the eyes, can cause papilledema, blindness.

Question 24

Clipping and Coiling procedures for aneurysms

Answer 24

Clipping: clips off the ballooned area of the vessel
Coiling: the ballooned area is filled in so nothing else can spill into it.

Question 25

A safer drug to give for seizurs in the ICU

Answer 25

Keppra aka Levetiracetam

Question 26

Seizure patients:

Keep Hgb __-__ g/dL (>7 for asymptomatic pts, and >10 for symptomatic vasospasm

Answer 26

8-10 g/dL

Question 27

Short course of ___ begun @ dx and continued until aneurysm/SAH is secured

Answer 27

antifibrinolytic therapy (Amicar or tranexamic acid)

Question 28

Noncontrast CT scan reveals a hyperdense clot which has an irregular border with the brain and causes more horizontal displacement (mass effect) than might be expected from its thickness. The disproportionate mass effect is the result of the large rostral-caudal extent of these hematomas

Answer 28

SUBDURAL HEMATOMA

Question 29

Noncontrast CT scan reveals The tightly attached dura is stripped from the inner table of the skull, producing a characteristic lenticular-shaped hemorrhage.

Answer 29

epidural hematoma

Question 30

Epidural hematoma’s are usually caused by tearing of the __ artery following fracture of the __ bone.

Answer 30

middle meningeal artery

temporal bone

Question 31

head CT shows bleeding within the brain matter, not around the perimeter:

Answer 31

Parenchymal hemorrhage