OnlineMedEd: Neurology - Stroke Flashcards
List the types of stroke.
•Ischemic:
- Embolic
- Thrombotic
•Hemorrhagic
Describe four classic vignettes for stroke.
A focal neurologic deficit in a(n)…
•Older, diabetic smoker with HTN and HLD
• Person with atrial fibrillation or valvular defects
• Young woman with neck pain after a minor trauma
•Person with a new-onset thunderclap headache
Strokes to the ____________ often cause syncope.
vertebral and basilar artery
When someone comes in with a focal neurologic deficit, you do a ________________.
non-contrast CT of the head
If you see hemorrhage in a non-contrast CT of the head, then you should _____________.
try to lower the patient’s BP and then call neurosurgery to do either a clip, coil, or craniotomy
If a non-contrast CT of the head shows no bleeding, then you know it is ______________.
an ischemic stroke
After you stabilize the patient with an ischemic stroke, you should do ________________.
an ECG (to look for atrial fibrillation), echocardiography (to look for valvular defects), and a carotid ultrasound (look
______________ is superior to stenting in the setting of carotid atherosclerosis.
Carotid endarterectomy
Note: this is only when the narrowing is greater than 70%.
What are the timeline criteria for giving tPA?
•Less than 3 hours (4.5 if the patient is not a diabetic)
tPA cannot be given to those with what factors?
- Systolic BP greater than 180
- Recent surgery
- Past intracranial bleed
Why should you let a person’s BP ride high after a stroke (if they’re not receiving tPA)?
The area around the ischemic tissue needs blood and high BP helps push that blood to the penumbra.
When would you add dipyramidole to aspirin after a stroke?
If the patient had a stroke on aspirin
Typically, you use clopidogrel for anticoagulation when ______________.
a person can’t tolerate aspirin
In addition to anticoagulation therapy, all patients who have strokes need to be given ______________.
statins and diabetes management
