Neuro emergencies Flashcards
Anterior Cerebral Artery occlusion affects what and where?
Contralateral sensory and lower motor extemity
Lacunar Infarcts of which artery?
Penetrating arteries
Which infarction is typically silent?
Lacunar infarction
Which artery MC for occlusion?
MCA
MCA occlusion presents how?
Contralateral sensory and motor loss
MCA occlusion loss greater in which two places?
Face and arm»_space; leg/foot
Occlusion of MCA on dominant side can cause hearing and speech issues called what?
Brocha (speech) and Wernicke (understanding)
Lower extremity, vertigo, ataxia from which artery?
PCA
Ataxia, nystagmus, vertigo, gait, and CN palsies from which artery?
Veterbo-basilar infarct
Time of onset of Intracerebral Hemorrhage?
Gradual. Minutes to hours.
Dx for Intracerebral Hemorrhage?
Non-con CT
MC cause of Intracerebral Hemorrhage?
HTN vasculopathy
BP and MAP goal in Intracerebral Hemorrhage?
160/90 or 110 MAP
PaCO2 for elevated ICP in Intracerebral Hemorrhage?
PaCO2 25-30mmHg
Tx for Warfarin induced Intracerebral Hemorrhage?
VitK
Tx for Rivaroxaban or Apixaban induced Intracerebral Hemorrhage?
Kcentra
Tx for Pradaxaban induced Intracerebral Hemorrhage?
Praxabind
SAH secondary to what?
Ruptured saccular “beri” anuerysm
Main risks for SAH?
Tobacco and HTN
Onset and description of HA in SAH?
Sudden onset, worst HA of life
Dx for SAH? What next if normal?
Non-con CT. If norml then LP for blood or Xanthrocomia
What GCS to intubate SAH?
<8
Tx for vasospam in SAH?
Nomodipine
When to intervene in SAH?
24-72h post SAH
Where are 85% of unruptured intracranial anuerysms located?
Anterior circulation, mostly circle of willis
Sx of unruptured intracranial anuerysms?
ASx until ruptured
What size can an MRA or CTA see an unruptured intracranial anuerysms?
5mm or larger
Tx of unruptured intracranial anuerysms if <7mm and no risk factors?
Observation
Where is Subdural Hematoma?
Btwen dura and arachnoid veins (outtermost membrane)
Subdural Hematoma venous or arterial bleed?
VENOUS
MC type of traumatic intracranial amss lesion?
Subdural Hematoma
Subdural Hematoma d/t tearing of which vein?
Bridging vein
When it acute Subdural Hematoma?
1-2d after trauma
Main dx of aucute Subdural Hematoma?
LOC
When it subacute Subdural Hematoma?
3-14d
When is chronic Subdural Hematoma?
> 15d
Onset of chronic Subdural Hematoma?
Insiduous onset. HA, dizzy, seizure, vomiting
CT shows what shape in Subdural Hematoma?
Crescent shape
Crescent Shape on CT from which bleed?
Subdural Hematoma
Epidural Hematoma located where?
Btwn dura and skull
Epidural Hematoma bleed from vein or artery?
Artery!
Epidural Hematoma bleed from which artery?
Meningeal artery
Epidural Hematoma due to?
Shearing force to side of head
Epidural Hematoma lucid followed by what?
Ludic followed by rapid deterioration and sudden unconsciousness
“Worst HA of life” which bleed?
Subarachnoid hemorrhage
Dx for Epidural Hematoma?
Head CT
What shape in Epidural Hematoma CT
Biconvex
Biconvex shape which ic bleed?
Epidural Hematoma
Which test CI’d in Epidural Hematoma?
LP
What GCS requires surgery in Epidural Hematoma?
GCS <9
How can small bleeds be treated in Epidural Hematoma?
Non-surgical
