Neuro: Cerebrovascular Disease Flashcards
What type of stroke?
diffuse, nonfocal sxs
circiulatory compromise
hypotension
bilateral sxs
hypoperfusion ischemic stroke
Hypodense on CT indicates…
ischemia
contralateral weakness/numbness face and arm > leg
contralateral homonymous hemianiopic gaze (look to lesion)
MCA stroke
Dominant or non-dominant hemisphere MCA stroke?
(+) global aphasia
dominant hemisphere
Dominant or non-dominant hemisphere MCA stroke?
(+) hemineglect
non-dominant
contralateral weakness/numbness in leg > face/rm
(+) abuila (delay in response)
perseverating speech
Visual field deficits from CN impingement
ACA
Contralateral homonymous hemianopia
reduced light-touch/pinprick sensation
may go unnoticed
PCA
Ipsilateral loss pain/temp sensation on face
contralateral body loss of sensation
vertico, ataxia, hiccups, ipsilateral horners syndrome
Wallenberg’s syndrome/PICA
Locked in syndrome
quadriplegia + facial/mouth/tongue weakness
EOMs and Blinking intact
basilar artery stroke
stroke associated with chronic HTN
lacunar
When to start BP tx for ischemic stroke…
220/120
keep BP less than… for hemorrhagic stroke
160-90
imaging of choice for stroke
non-contrast CT
Tx for acute ischemic CVA…
ASA
mechanical thrombectomy can be used for which strokes?
intracranial large artery proximal anterior
Tx for hemorrhagic stroke
reduce ICP (elevate bed, mannitol, csf cath, etc)
stop anticoags + antidote
What HTN med to keep BP < 160/90 in hemorrhagic stroke?
nicardipine
3 imaging modalities to help lessen progression of TIA to CVA
EKG for afib
carotid ultrasound
CTA head and neck
High risk HA + normal CT
LP for bleeding
what population for SAH?
40-60 women
leading causes of death after SAH
vasospasm (CVA)
re-bleeding
On CSF analysis, RBCs decrease from tube 1 to tube 4… what does this indicate?
traumatic tap
xanthochromia on CSF indicates…
SAH
With SAH, what imaging must be ordered to monitor for vasospasm?
TCD
SAH tx to prevent vasospasm
IV fluids + nimodipine
