Stroke Flashcards

1
Q

Non-modifiable risk factors for stroke

A
  • age
  • gender
  • ethnicity or race
  • family hx
  • heredity
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2
Q

Modifiable risk factors for stroke

A
  • HTN
  • heart disease
  • diabetes mellitus
  • smoking
  • excessive alcohol consumption
  • obesity
  • sleep apnea
  • metabolic syndrome
  • lack of exercise
  • poor diet
  • drug abuse
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3
Q

Characteristics of transient ischemic attack (TIA):

Carotid system

A
  • temporary loss of vision in one eye
  • transient hemiparesis
  • numbness or loss of sensation
  • sudden inability to speak
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4
Q

Characteristics of transient ischemic attack (TIA):

Vertibrobasilar system

A
  • tinnitus
  • vertigo
  • darkened or blurred vision
  • diplopia
  • ptosis
  • dysarthria
  • dysphagia
  • ataxia
  • unilateral or bilateral numbness or weakness
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5
Q

Ischemic strokes

A
  • thrombotic

- embolic

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6
Q

Hemorrhagic strokes

A
  • intracerebral

- subarachnoid

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7
Q

Thrombotic stroke

A
  • results from injury to blood vessel and blood clot formation
  • warning: TIA (30-50% of cases)
  • onset: often during or after sleep
  • S&S develop slowly, usually some improvement, recurrence in 20-25% of survivors
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8
Q

Embolic stroke

A
  • occurs when an embolus lodges and occludes a cerebral artery
  • warning: TIA (uncommon)
  • onset: lack of relationship to activity, sudden onset!
  • single event, D&S develop quickly, usually some improvement, recurrence common without aggressive tx of underlying disease
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9
Q

Intracerebral stroke

A
  • bleeding within the brain caused by a rupture of a vessel (most important cause-HTN)
  • warning: headache (25% of cases)
  • onset: activity (often)
  • progression over 24 hour
  • poor prognosis, fatality more likely with presence of coma
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10
Q

Subarachnoid stroke

A
  • intracranial bleeding into CSF-filled space between arachnoid and pia mater
  • warning: headache (common)
  • onset: activity (often), sudden onset, most commonly related to head trauma
  • usually single event, fatality more likely with presence of coma
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11
Q

Clinical manifestations for pt who have had a stroke

A

Motor function impairment:

  • mobility
  • respiratory function
  • swallowing and speech
  • gag reflex
  • self-care abilities
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12
Q

Right-brain stroke

A
  • paralyzed left side: hemiplagia
  • left-sided neglect
  • spatial-perceptual deficits
  • tends to deny or minimize problems
  • rapid performance, short attention span
  • impulsive, safety problems
  • impaired judgement
  • impaired time concepts
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13
Q

Left-brain stroke

A
  • paralyzed right side: hemiplagia
  • impaired speech/language aphasia
  • impaired right/left discrimination
  • slow performance, cautious
  • aware of deficits: depression, anxiety
  • impaired comprehension related to language, math
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14
Q

Drug tx for pts with ischemic strokes

A
  • thrombolytic (fibrinolytic) therapy
  • TPA within 3-4.5 hours of onset of stroke
  • Anticoag therapy
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15
Q

Surgical tx for pts with ischemic strokes

A
  • stent retrievers-way to open blocked arteries

- mechanical embolus removal in cerebral ischemia (MERCI) retriever

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16
Q

Drug tx for pts with hemorrhagic stroke

A

-drugs to manage HTN
(oral and IV agents to keep BP in normal limits)
-seizure prophylaxis in acute period after (situation specific)

17
Q

Surgical tx for pts with hemorrhagic stroke

A
  • immediate evacuation of aneurysm-induced/cerebral hematomas >3 cm
  • arteriovenous malformation (AVM)-resection and/or radiosurgery (gamma knife)
  • “clipping” aneurysm