QBank Flashcards
Broca’s - What division MCA?
Upper Division MCA CVA
Wernicke’s - What division MCA?
Lower Division MCA CVA
Most significant stroke risk factor?
Age
Greatest modifiable risk factor for stroke?
Smoking
Percentage of strokes that are ischemic?
87%
Cranial nerves located in the forebrain
CN 1 and 2 (Olfactory and Optic)
Transient bilateral visual loss
Amaurosis Fugax
Amaurosis Fugax is ass with occlusive DZ of?
ICA
What strokes can lead to personality changes?
ACA (Anterior Cerebral Artery)
Pts deny their blindness despite objective evidence of visual loss and confabulate their stories
Anton’s Syndrome
What artery supplies the medulla?
Vertebral arteries
Decreased pain / temp on ipsilateral face and contralateral body, and ataxia
Wallenberg Syndrome (Lateral Medullary Syndrome)
Ipsilateral CN3 palsy and contralateral hemiplegia
Weber Syndrome
CN12 palsy, contralateral hemiplegia and contralateral tactile sensory loss
Medial medullary syndrome (think hypoglossal)
Ipsilateral CN6 palsy, contralateral hemiplegia and contralateral sensory loss
Millard-Gubler syndrome
What area lesion results in pure motor hemiplegia?
Posterior limb of the internal capsule
What area lesion results in pure sensory loss?
Thalamic
What area of hemorrhagic CVA is most detrimental
Pons. Pts may only survive if < 1 cm
Hunt and Hess scale for Subarachnoid hemorrhage
- Asymptomatic, mild HA, mild nuchal rigidity
- Mod-severe HA, nuchal rigidity
- Drowsiness / Confusion
- Stupor, Hemiparesis
- Coma, Decerebrate posturing
Percent mortality after SAH?
25%
At what MAP should anti-HTN be started and which anti-HTN?
MAP > 130 mmHg. Beta-blockers preferred
What med should be started if suspected SAH to prevent vasoaspasm?
Nimodipine
What strokes are most likely to occur when sleeping?
Thrombotic strokes
What medication is approved for pseudobulbar affect?
Neudexta (dextromethorphan / quinidine)
What therapy focuses on abnormal movement in attempt to improve motor contral?
Brunnstrum approach
What motion must be intact before starting constraint-induced therapy?
Wrist extension
What test is most sensitive an specific when trying to diagnose CRPS?
Triple-phase bone scan
What stroke has the strongest association with dysphagia?
Brainstem (think hypoglossal)
Decreased output of nouns and word finding difficulty
Anomia
Act of meaningless repetition
Echololia
New words that are meaningless to everyone other than patient
Neologisms
Goal ICP in acute stroke patient
ICP < 20 mmHg
Repetitions of slow exercises used to treat ataxia
Frenkel exercises
Dysphagia, dysarthria and emotional lability
Pseudobulbar Palsy
Saccular aneurysms are most commonly found in what vessel?
Anterior circle of willis
Upper division MCA CVA - stronger legs or arms?
Stronger legs
Alexia without agraphia with what kind of stroke?
PCA (posterior cerebral artery) CVA
Prognosis for functional improvement after Wallenberg syndrome?
Good prognosis
Contralateral chorea (affects red nucleus)
Benedikt’s syndrome
Cutaneous stimulation, proprioceptive maneuvers
Rood Approach