Neurology - Seizure, Stroke & EMS

Question 1

What two portions of the brain are required for us to be “awake” or “aware?”

Answer 1

• 1/2 of the cerebral cortex - brain stem

Question 2

The old means of assessing AMS involved what mnemonic?

Answer 2

Question 3

The “Scheppke Simplification System” states that a neuron will cause AMS if _____ is interrupted.

Answer 3

its normal cellular f(x)

• change to glucose metabolism
• change to its oxygen/blood supply

(Starve, destroy, or poison the brain)

Question 4

Starving the brain means loss of ______.

Answer 4

• blood flow (starves brain of glucose and oxygen)

Question 5

1* cause of “brain starvation” is _____.

Answer 5

Stroke

Question 6

Ischemic stroke occurs in approximately _____% of stroke cases.

Answer 6

87%

Question 7

Hemorrhagic stroke occurs in approximately _____% of stroke cases.

Answer 7

13%

Question 8

Vascular events (stroke, PE, etc) quickly shut down blood flow to (localized/generalized) regions.

Answer 8

localized

Question 9

BE-FAST picks up regions aff?

Question 10

“Destroy the brain” arises from?

Answer 10

• Tumor - slow onset
• Trauma - TBI
• Stroke - sudden onset

Question 11

How can a hemorrhagic stroke result in AMS/unconsciouness if the bleed only arises from one vessel?

Answer 11

The cranial vault is a fixed volume. As blood pools in the skull, it shifts the brain the opposite direction. This puts pressure on both sides of the cerebral cortex –> AMS/unconsciouness, though the brain stem usually remains intact.

Question 12

The “poisoning of the brain” often occurs from ___ in the elderly.

Answer 12

• sepsis

Question 13

A transient occurence of signs and/or symptoms caused by abnormal electrical activity in the brain

Answer 13

Seizure

Question 14

A neuro condition characterized by two or more unprovoked seizures occurring in < 24 hours

Answer 14

epilepsy

Question 15

Abnormally prolonged seizures (lasting > 5 min)

Answer 15

Status epilepticus

Question 16

Most damaging type of stroke is the ____ occlusion.

Answer 16

large vessel (kills large amount of parenchyma)

Question 17

Stroke symptoms that involve the brain itself are called _____ symptoms.

Answer 17

cortical

Question 18

For the VAN assessment, slurring speech (is/is not) a sign of aphasia.

Answer 18

Is not

• Producing and understanding speech is aphasia.

Question 19

Why is vision, aphasia, and neglect assessed in VAN?

Answer 19

These three areas are controlled by three regions of the brain, so it makes it easy to assess.

Question 20

What is meant by “lacunar” stroke?

Answer 20

The lacunae are small arteries deep within the brain, and supply very small regions of the brain. When these vessels are blocked, the result in a small area of ischemia.

Compared to LVOs (which involve large portions of the cerebral cortex), the deficits of lacunar strokes may be small.

Question 21

Which regions are tested by VAN?

Answer 21