Stroke Flashcards
What is the acronym for stroke?
F: facial drooping
A: arm weakness
S: speech difficulty
T: time
Aside from the general FAST symptoms, what are other symptoms we should be aware of that might be indicative of stroke?
- Sudden numbness/weakness of the leg
- Sudden confusion or trouble understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance/coordination
- Sudden severe HA w/no known cause
How long does a transient ischemic attack (TIA) last for?
few minutes but not longer than 24 hrs
Why is a TIA such a big deal?
it is a precursor to susceptibility for both cerebral infarction & myocardial infarction
What is a deteriorating stroke?
when their neurological status deteriorates after admission to the hospital
Severity and symptoms are depednent on what 4 factors?
- Location of the stroke area
- Size of the stroke area
- Nature & functions of structures involved
- Availability of collateral blood flow
What impact does PaCO2 and PaO2 have on vasodilation & vasoconstriction?
-Vasodilation & increased CBF are produced in response to increase in PaCO2 or decrease in PaO2 whereas vasoconstriction and decreased CBF are produced by the opposite stimuli
What impact does pH have on vasodilation and vasoconstriction?
fall in pH produces vasodilation and increase in pH causes vasoconstriction
What areas does the ACA supply? (2)
-frontal & parietal lobes
-basal ganglia
What are the common S&S we would expect to see in a stroke involving the ACA? (4)
-Contralateral hemiparesis
-Sensory loss w/greater involvement of LE>UE
-Aphasia’s (Broca’s in frontal lobe & Wernicke’s in parietal)
-Urinary incontinence
What areas does the MCA supply? (3)
-frontal, temporal, and parietal lobes
What is the main concern with occlusion of a proximal MCA?
it produces extensive neurological damage with significant cerebral edema; increased ICP typically leads to LOC, brain herniation, and possibly death
What are the common S&S we would expect to see in a stroke involving the MCA? (5)
-Contralateral spastic hemiparesis
-Sensory loss of the face
-UE>LE
-Broca’s & Wernicke’s aphasia
-Limb kinetic apraxia
-Ataxia of contralateral limbs
Lesions of the parieto-occipital cortex of the dominant hemisphere (typically L) typically produce what?
aphasia
Lesions of the R parietal lobe of the nondominant hemisphere (typically R) typically produce what?
perceptual deficits (unilateral neglect, anosognosia, apraxia, spatial disorganization)
What is another common finding with MCA infarct?
homonymous hemianopsia
Which area of the brain is the most common site of occlusion in stroke?
MCA
Occlusion of the ICA typically produces what?
massive infarction in the region of the brain supplied by the MCA
What is our main concern with an internal carotid artery infarct?
-significant edema with possible uncal herniation, coma, and eath
What does the PCA supply? (2)
-occipital lobe & parts of the temporal lobe
-upper brainstem & midbrain
What would be common S&S we would expect to see with a PCA stroke? (4)
-Contralateral homonymous hemianopsia
-Visual agnosia
-Prosopagnosia (difficulty naming ppl)
-Topographic disorientation
What is a lacunar stroke?
caused by small vessel disease deep in the cerebral white matter (penetrating artery disease); strongly associated with hypertensive hemorrhage
What do the vertebral arteries supply in the brain? (2)
How about the basilar artery? (1)
-cerebellum
-medulla
-pons
What are some common S&S we might expect to see with a vertebrobasiliar artery stroke? (4)
-Ipsilateral to lesion (paralysis w/atrophy of 1/2 the tongue w/deviation to paralyzed side)
-Contralateral to lesion (paralysis of UE & LE)
-Impaired tactile & proprioceptive sense
-Horner’s syndrome (miosis, ptosis, decreased sweating)
