S2_L2: Stroke Flashcards
Known as the first stroke neurologist who analyzed the distribution of infarcts in various arterial territories and correlated brain lesions with clinical findings.
Charles Foix
Determine whether the finding is true for Weber, Benedikt, or both.
- Parasympathetic involvement; ptosis
- Ipsilateral CN III Palsy
- Tremors, involuntary movement of opposite limbs
- Contralateral hemiparesis
- Contralateral ataxia
A. Weber’s Syndrome
B. Benedikt’s Syndrome
C. both
- A
- C
- B
- C
- B
TRUE OR FALSE: Weber is caused by involvement of the fascicles of the 3rd nerve within the midbrain, while Benedikt’s is also caused by that along with the involvement of the cerebral peduncle & red nucleus.
True
TRUE OR FALSE: Affectation of the crus cerebri results in contralateral hemiparesis that is present in Weber Syndrome and Benedikt’s Syndrome.
True
Source: Snell, Ninja Nerd
In ipsilateral cranial nerve III palsy, the eyeball is deviated laterally because of the paralysis of what muscle?
Medial rectus
Source: Snell
Determine whether the structure affected is true for Wallenberg Syndrome, Medial Medullary Syndrome, or both.
- Nucleus ambiguus
- Cerebellum (inferior cerebellar penducle)
- Hypoglossal nerve (CN XII)
- Corticospinal / Pyramidal Tract
- Medial lemniscus
A. Wallenberg Syndrome
B. Medial Medullary Syndrome
C. both
- A
- A
- B
- B
- B
Determine whether the structure affected is true for Wallenberg Syndrome, Medial Medullary Syndrome, or both.
- Spinal trigeminal nucleus of CN V
- Vestibular nuclei
- Descending sympathetic fibers
- Vertebral Artery (Anterior Spinal Artery)
- Posterior Inferior Cerebellar Artery
- Spinal lemniscus (Spinothalamic tract)
A. Wallenberg Syndrome
B. Medial Medullary Syndrome
C. both
- A
- A
- A
- B
- A
- A
Determine whether the finding is true for Wallenberg Syndrome, Medial Medullary Syndrome, or both.
- Vertigo, nausea, nystagmus
- Contralateral hemiparesis
- Ipsilateral Horner’s Syndrome
- Contralateral body thermo-analgesia
- Contralateral decrease in vibration and position sense
A. Wallenberg Syndrome
B. Medial Medullary Syndrome
C. both
- A
- B
- A
- A
- B
Determine whether the finding is true for Wallenberg Syndrome, Medial Medullary Syndrome, or both.
- Ipsilateral bulbar palsy
- Ipsilateral ataxia
- Ipsilateral tongue weakness with deviation to paralyzed side when tongue is protruded
- Ipsilateral facial sensory loss & numbness
- Oscillopsia
A. Wallenberg Syndrome
B. Medial Medullary Syndrome
C. both
- A
- A
- B
- A
- A
What does FAST stand for?
Facial weakness
Arm weakness
Speech problems
Time
This infarct appears in the sinuses and one of its common causes is the intake of oral contraceptive medications in women
Venous infarct
C. Miller Fisher states, “Stroke is a neurological deficit of sudden onset accompanied by focal dysfunction and symptoms lasting more than ___ that are presumed to be of non-traumatic vascular origin.”
24 hours
The first most common cause of death in the world is (1)___, while the second is (2)___.
- Heart disease
- Stroke
It is the occlusion of the vessel by propagation of a thrombus. Over time, the occlusion depends on the size and location of the vessel and collateral flow.
Thrombotic infarct
Additional: Collaterals have more time to expand if the occlusion occurs over time.
This stroke’s predisposing factors are pregnancy and other hypercoagulable states. Patients present any combination of headache, seizures, cognitive difficulty, and focal weakness.
Venous infarct
Additional: Less common than arterial infarct
Determine if epidural or subdural hemorrhage is described.
- Due to trauma where the middle cerebral artery is ruptured
- Caused by tearing of the meningeal arteries
- Bleeding is most often slow and accumulates during days, weeks, and a few months
- Blood accumulates rapidly over minutes to hours between the skull and the dura mater
- Due to venous trauma located between the dura mater and arachnoid membranes
A. Epidural hemorrhage
B. Subdural hemorrhage
- A
- A
- B
- A
- B
A patient presents with signs and symptoms of acute CNS bleeding. A CT was performed and it showed (+) bleeding. What emergency management would be considered for the patient?
Surgery
A patient in the ED presents with a suspected infarction. They arrived at 5PM. The caregiver shared that the patient was last seen normal at 2PM. What emergency management would be considered for the patient?
tissue plasminogen activator (t-PA)
Enumerate the 5 stroke warning signs
- Weakness (especially on one side of body)
- Trouble speaking
- Vision problems
- Headache
- Dizziness
After obtaining brain imaging, the patient presents with ischemic stroke / TIA. What management would be considered for the patient?
Thrombolysis / thrombectomy
After obtaining brain imaging, the patient presents with hemorrhage. What management would be considered for the patient?
Lowering the BP
A patient presents with a hemorrhage. Aneurysmal subarachnoid hemorrhage (SAH) is the established cause. What management would be considered for the patient?
Clip or coil
A patient presents with a hemorrhage. If the established cause is an intracerebral hemorrhage (ICH) or hypertension, what management would be considered for the patient?
Surgery
A patient has ischemic stroke/TIA. Atrial fibrillation is the established cause. What management would be considered for the patient?
Warfarin