Stroke

Question 1

List modifiable risk factors for stroke

Answer 1

Smoking
Diet
HTN
DM
Cholesterol
Obesity
Environmental factors
Exercise

Question 2

List non-modifiable risk factors for stroke

Answer 2

Age
Gender
Secondary to surgical procedure
Race
Ethnicity
Genetics
Family History

Question 3

If a stroke occurs in the anterior cerebral artery, what area of the brain is affected?

Answer 3

Prefrontal
Primary Motor Cortex

Question 4

If a stroke occurs in the posterior cerebral artery, what area of the brain is affected?

Answer 4

Primary visual cortex

Question 5

The MCA and ACA are derived from which artery?

Answer 5

Internal carotid artery

Question 6

MCA supplies blood to which areas?

Answer 6

Large area of frontal, parietal, and temporal lobes

Question 7

ACA supplies blood to which areas?

Answer 7

Medial portion of frontal and parietal lobes

Question 8

PCA supplies blood to which area?

Answer 8

Occipital lobe

Question 9

Occlusion to MCA causes what dysfunction?

Answer 9

Face, UE, language and speech

Question 10

Occlusion to ACA causes what dysfunction?

Answer 10

Cortical area supplying primarily to LE

Question 11

Occlusion to PCA causes what dysfunction?

Answer 11

Visual deficits

Question 12

Describe presentation of stroke on the right side of brain

Answer 12

Left hemiparesis
Visual-perceptual deficits (neglect(
Poor judgement, cognitive/behavioral issues (impulsiveness)

Question 13

Describe presentation of stroke on the left side of brain

Answer 13

Right hemiparesis
Language deficits
Apraxia
Processing delays, perseveration (stuck on activity)

Question 14

What are the two types of ischemic CVAs?

Answer 14

Thrombotic Infarction
Embolic Infarction

Question 15

Describe the thrombus in thrombotic CVAs?

Answer 15

Atherosclerotic plaques in first major branchings of large cerebral arteries

Question 16

Presentation of thrombotic CVA

Answer 16

Some symptoms of stroke, patients can wake up feeling fine but progressively worsens throughout day
*dizziness when getting up quickly

Question 17

Common risk factors of thrombotic CVA

Answer 17

HTN
DM
cardiac/vascular disease

Question 18

Where is the thrombus in embolic CVAs?

Answer 18

Outside the brain

Question 19

Where are the thrombus lodged in embolic CVA?

Answer 19

Medium-sized vessels
(MCA, vertebral or basilar branches)

Question 20

What is the rate of mortality if the thrombus is lodged in the basilar artery?

Answer 20

High

Question 21

Presentation of symptoms in embolic CVA?

Answer 21

Can present with facial paralysis and then resolves. Later, presents with arm paralysis as clot moves.

Question 22

What is a hemorrhagic CVA?

Answer 22

Abnormal bleeding in the brain

Question 23

Causes of hemorrhagic CVA

Answer 23

HTN
Aneurysm
AV malfunction

Question 24

Are hemorrhagic CVA’s more focal or global?

Answer 24

Global
Presents like a TBI

Question 25

How long do transient ischemic attacks (TIA) last?

Answer 25

< 24 hours

Question 26

What is interrupted in TIA?

Answer 26

Brain blood flow

Question 27

Why do we flag history of TIAs during subjective exam?

Answer 27

It can evolve into a thrombus or small emobili
This is a high risk factor (need to provide patient education)

Question 28

Why is a CT scan a preferred diagnostic test?

Answer 28

Faster, Safer
Good for seeing brain fluid! (Ischemic vs hemorrhagi)