Neurology_Stroke Flashcards
What is the most common cause of neurologic disability nd the third leading cause of death in the US?
- stroke,
what is a transient ischemic attack(TIA)?
- It is an ischemic induced focal neurologic deficit lasting less than 24 hours usually less than one hour.
What are Common Signs of in symptoms of a TIA?
- ipsilateral blindness (amaurosis fugax)
- unilateral hemiplegia
- hemiparesis
- weakness
Why is a TIA important to diagnose?
- may be a precursor to stroke.
What are the two kinds of strokes?
- Ischemic and
- hemorrhagic
which type stroke is more common?
- ischemic strokes about 80%
What causes an ischemic stroke?
- thrombus or an embolus.
What causes a hemorrhagic stroke?
- intra-cerebral hemorrhage?
What is the most common cause of hemorrhagic stroke?
- hypertension
what other causes of strokes?
- coagulopathy
- septic embolus from endocarditis
- sickle cell disease
- Ruptured aneurysm
- arteriovenous malformation
- malignancy.
What are the signs and symptoms of stroke?
- Severe headache
- vomiting
- mental status changes
- Nuchal rigidity
- hemisensory loss
- Hemiparesis
- amaurosis fugax
- aphasia
- ataxia
What is the initial Imaging study you should order if you suspect a stroke?
- CT scan of the head without contrast.
According to the American Heart Association, or American Stroke Association guidelines, what other diagnostic tests should be performed to evaluate a suspected stroke or TIA?
- Magnetic Resonance Imaging
- ECG
- non-invasive imaging of the cervicocephalic vessels
which are the non invasive options for imaging the cervicocephalic vessels? c
- carotid Doppler
- Magnetic Resonance angiography
- CT angiography.
When can thrombolysis with tissue-plasminogen activator (TPA) be used in a patient with confirmed ischemic stroke?
- patient presents within the first three hours of onset of the symptoms and must meet the right criteria for its use.
What are the contraindications of tPA?
- uncontrolled hypertension
- intracranial pathology e.g.
- bleeding neoplasm
- atrioenous malformation
- recent major surgery presents
- recent serious head trauma
- Recent stroke
- seizure at the onset of the stroke
- high risk of bleeding
- eg on heparin within the last 48 hours
- abnormal partial thromboplastin time
- platelet count < 100,000.
According to the American Heart Association, or American Stroke Association and the American College of Chest Physicians guidelines, which antiplatelet agent can be used for secondary ischemic stroke prevention?
- aspirin 50 to 325 milligrams orally once daily
- clopidogrel 75 milligrams orally once daily, or
- extended release dipyridamole 200 milligrams/ Aspirin 25 milligrams PO two times daily
dose aspirin plus clopidogrel offer greater benefit than either medication alone?
No
