Neuro Flashcards
_____ is the most common type of Subarachnoid Hemorrhage
Berry aneurysm
*AVM is another type
What are the S&S of a subarachnoid hemorrhage?
Thunderclap HA “worst HA of my life”, unilateral
-Meningeal sx- stiff neck, photophobia, delirium
How is a subarachnoid hemorrhage diagnosed?
CT scan performed 1st!
-If CT negative- LP (look for xanthochromia- RBC. Increased CSF pressure)
How is a SAH treated?
Supportive, bed rest, stool softeners, surgical coiling/clipping
-Nicardipine
What causes a subdural hematoma?
Tearing of cortical bridging veins. MC in elderly!
- Dx- CT scan- Concave (crescent shaped)
- *Bleeding CAN cross suture lines
How is a subdural hematoma treated?
Supportive if small.
-Hematoma evacuation- if massive or ≥ 5mm midline shift
What causes an epidural hematoma?
MC after a Temporal bone fx–> middle meningeal artery disruption
What are the S&S of an epidural hematoma?
Brief LOC with lucid interval–> coma, HA, N/V, focal neuro sx, rhinorrhea
- Dx- CT- convex (lens)
- *Bleeding does NOT cross suture lines
How is an epidural hematoma managed?
+/- herniation if not evacuated early
- observation if small
- if increased ICP: mannitol, hyperventilation, head elevation +/- shunt
Ischemic stroke most often occurs in the ______.
Middle Cerebral Artery
What are the S&S of an ischemic stroke?
Contralateral sensory/motor loss: GREATER IN FACE, ARM
-gave preference toward side of lesion
Dominant (usually L-side)- aphasia: Broca (expressive), Wernicke (sensory), math comprehension, agraphia
Nondominant (usually R-side)- spatial deficits, dysarthria, left-side neglect, anosognosia, apraxia
How is an ischemic stroke diagnosed?
Non-contrast CT scan to r/o hemorrhage!
How is an ischemic stroke treated?
Thrombolytics within 3 hours (rTPA)
Antiplatelet therapy (ASA, Clopidogrel, etc) if > 3 hr or 24hr after lytics
Lower BP if > 185/110 for thrombolytics or > 220/120 if no thrombolytic use or if MAP > 130
