Stroke Flashcards
In wake up stroke, whatbis the imaging modality used to diagnose it?
MRI (Diffusion +ve; FLAIR - ve)
What is the test that must be done before giving alteplase in stroke?
Blood glucose
In stroke, What is the cut off blood pressure value above which I can not give rTPA?
220/120
In stroke, Before giving rTPA, what is the goal blood pressure?
Less than 185/110
IN STROKE What is the goal blood pressure after giving rTPA?
<180/105
Blood glucose level range when giving rTPA?
140- 180
What is Maximum dose allowed in rTPA (IV alteplase)
90 mg over 60 mins
In stroke, NIHSS Score required for giving IV rTPA
> 5
. IV alteplase is not recommended with nondisabling symptoms (NIHSS 0 to 5)
In stroke, For a patient with cerebral microbleeds <10, should we give him IV alteplase?
Yes
In stroke, For a patient with cerebral microbleeds >10, should we give him IV alteplase?
No, it increases risk of intracerebral hge.
Should A patient who has been treated with full treatment dose of low-molecular-weight
heparin (LMWH) in the previous 24 hours receive iv alteplase?
No
Following the initiation of IV alteplase, IV aspirin should not be administered within…..
90 mins
In the 24 hours after IV alteplase treatment, the patient’s BP should be maintained at….
Less than 180/105
What is the time frame during which i can give iv alteplase in stroke
4.5 hrs
In stroke, after iv RTPA, when is antithrombotic agent given?
Antithrombotic given 24 hrs post infusion
Time frame of mechanical thrombectomy in stroke
Within 6 hours
Maintain BP at… /…. mm Hg or less during mechanical thrombectomy and
for 24 hours after the procedure.
180/105 mmHg
Asprin should be given after…… Of givingiv alteplase
24 hrs
In stroke, Antihypertensive used for lowering BP before giving iv alteplase
Labetalol, NiCARdipine o Clevidipine
• For a patient with AIS who has a BP greater than 220/120 mm Hg, who is not receiving IV
alteplase or EVT, and who has no comorbid hypertensive disease, consider lowering the BP by……….
% in the 24 hours after the onset of AIS.
15%
In most AIS patients with atrial fibrillation, starting anticoagulation between day… and…..
post event is recommended.
• The most common cause of fever in the first 48 hours after acute
stroke is…….
Pneumonia
Most seizures associated with stroke are….
Focal
• Bihemispheric strokes can result in………… respiration
Cheyne- stokes respiration
Tx of post stroke depression
Fluoxetine
Cerebral blood flow in an infarcted core
<10 mL/100 g/min
Cerebral blood flow in a penumbra (pre infarction) (stroke)
17 to 10 mL/100 g/min
Duration of neurological deficit in stroke?
> 24 hrs
Duration of neurological deficit in TIA ?
< 24 hrs (without acute infarction or tissue injury)
Typical duration of TIA?
< 1 hr (often minutes )
Mortality rate of stroke?
25%
Types of stroke?
- Ischemic, blockage of:
A. Small vessel
B. Large vessel
C. Cardio-embolic - Hemorrhagic: ruptured BV
Most common type of stroke?
Ischemic stroke
Most common cause of hemorrhagic stroke?
Uncontrolled HTN
Type of weak BV in hemorrhagic stroke?
- Aneurysms
- Arterio-venous malformations
Types of ischemic stroke?
- Embolic
- Thrombotic
Sites of ruptured BV in hemorrhagic stroke?
- Inside the brain
- In the membrane surrounding the brain
Ischemic core & penumbra?
- Normal CBF: 50mL/100g/min
- Benign oligemia: CBF>17mL/100g/min
- Penumbra: 17 to 10 mL100g/min
- Infarct core: <10 mL/100g/min
