Part 4 stroke Flashcards
________: walled off and removed by macrophages
small infarct
___________:walled off, becomes a cyst–>a hole, permanent and no regeneration
Large infarct
Treating stroke: ischemic stroke–> _______, thrombolytics–>if no response, surgery
Surgery–>MERCI, suction removal, stent retrieval
Aspirin
Treating Stroke: Hemorrhagic stroke
No anti-platelets or anti-coagulants; no thrombolytics
Stop warfarin or aspirin
Manage symptoms+complications
Anti-hypertensive–>decrease bleeding
Anti-convulsant–>increase risk of seizures –>abnormal electrical activities
Surgery
Clip aneurysm
Coil embolization–>clotted up coil inside aneurysm
Acute treatment of ischemic stroke
Hospital, ________,thrombolytic “clot bluster” tpa–>plasmin
may require further surgical intervention
Aspirin
Acute treatment of hemorrhagic stroke
You want ___________
Don’t give tPA
Heart starts pump harder
Anti-hypertensives (to further reduce bleeding)
Stop warfarin or aspirin
Have the head elevated (to lower pressure in the skull)
Intracranial pressure disrupts normal electrical activity in the brain–>potential for seizure–>anti-convulsant
Compression of areas like brainstem is often quickly fatal
Manage the pt until surgical interventions if required
coagulation
Watershed ischemia is a brain ischemia that occurs in the areas furthest from the major arterial supply, making them more susceptible to reduced blood flow.
Location: these border zones are located in the distal junction bwn two non-anastomotic arterial territories (meaning they don’t connect directly)
Cause: watershed strokes are caused by cerebral ____________(reduced blood flow to the brain), decreased cerebral blood flow, and arterial embolism in unstable atheroma plaque.
hypoperfusion
Watershed regions of the brain most suspectible to ischemia
Watershed stroke gradual thing of restricting blood flow to these border zones not now under ischemia
Hemorrhagic stroke can cause ischemic stroke!!!!!!
