Neuro 2.2 Flashcards
How does TIAs look on imaging?
They don’t, fool.
How often do you do the ABCD score?
2, 7, and 90 days after CVA
What do you get points for in the ABCD score?
Age > 60 years (1 point)
BP = 140/90 mmHg at initial evaluation (1 point)
Speech disturbance without weakness (1 point) OR
Unilateral weakness (2 point)
Duration of symptoms of 10-59 minutes (1 point) OR
Duration of symptoms >60 minutes (2 point)
DM mellitus in patient’s history (1 point)
ABCD score where hospital observation is unnecessary
0-3
ABCD score where hospital observation is justified
4-5
ABCD score where hospitalization is worthwhile
6-7
If a TIA is probable, what do you do?
Apply ABCD score, aspirin, refer to TIA clinic
What does ABCD stand for?
age; blood pressure; clinical features of TIA; duration; diabetes
Treatment for patient with TIA and a. fib
anticoagulants
Treatment for patients with TIA and mural thrombus
anticoagulants
All patients with TIA treatment:
ASA
ASA + dipyridamole
Clopidogrel
ASA + clopidogrel
Are anticoagulant drugs recommended in the average patient with a TIA?
No
When do you start OAC in patient with TIA and a.fib?
1 day after acute event
When do you start OAC in patient with mild stroke and a.fib?
3 days after acute event
When do you start OAC in patient with moderate and a.fib?
6 days after acute event
When do you start OAC in patient with severe and a.fib?
16 days after acute event
Mild stroke NIHSS
<8
Moderate stroke NIHSS
8-15
Severe stroke NIHSS
> 16
Recurrent TIAs with identical clinical features are usually caused by
thrombosis or embolism arising from the same site within the cerebral circulation
TIAs that differ in character from event to even suggest ?
recurrent emboli from distant or multiple sites
What’s the most common cause of embolic stroke?
a. fib
Name five causes of embolic stroke?
a. fib; migraine; arterial dissection; temporal arteritis; sickle cell anemia
Name the 5 classic lacunar syndromes
pure motor stroke; pure sensory stroke; ataxic hemiparesis; clumsy hand-dysarthria; sensory-motor