stroke Flashcards
define stroke
rapidly developing focal or global disturbance of brain function for more than 24 hours leading to death c no apparent cause other than vascular origin
abrupt onset of neurologic deficit that from a focal vascular cause
discuss TIAs
abrupt rapidly fading episodes of neurologic deficit na vascular origin
lasts less than 24 hrs and usually less than 1 hr lng
no evidence of infarct on imaging
predictor of strokes
discuss how TIAs are predictor of stroke
10-20% chance within 90 days after TIA
50% chance within first 2 days p TIA
discuss non-modifiable risk factors in stroke
elderly greater risk
more in males
fam hx greater risk
non-white is greater risk - darker u get
prior stroke or MI is greater risk
heart disease is greater risk
discuss modifiable lifestyle factors in stroke
smoking
low physical exercise
morbid obesity
excess alcohol
high fat and salt
discuss modifiable pharmacotherapy factors in stroke
HTN
arterial diseases
heart disease or failure
risk of thrombolic or embolic phenomena
certain blood disorders
high blood cholesterol
DM
types of ischemic stroke
thrombotic - occlusion of arteries/veins
embolic - from great vessels or heart
lacunar
venous
discuss causes if ischemic stroke
thrombotic occlusion of arteries/veins
embolic disease from great vessels or heart
occlusion of small penetrating vessels
hypoefusion
types of hemorrhagic stroke
subdural
epidural
subarachnoid
intraparenchymal
hemorrhagic transformation of ischemic stroke
discuss causes if hemmorhagic stroke
breakage of the blood vessel d/t HTN or aneurysm
trauma, penetrating injury, shearing injury
fragile vessels from infarction
most common clinical findings of stroke
acute onset of focal deficit
- weakness
- sensory loss
- ataxia
- speech deficit
- vision loss
discuss embolic infarct
arises from heart, aorta or carotid or vertebral arteries
from valvular disease, akinetic myocardium, right-to-left shunt from septal defect
discuss thrombotic infarct
occlusion of vessel by propagation of thrombus - overt time and sx depends on size and location
collateral flow - more time to expand if occlusion happen over time
discuss venous infarct
much less common than arterial infarction
pregnancy and hypercoagubale states
focal weakness, HA, cognitive difficulty and seizures
discuss subarachnoid hemorrhage
d/t rupture of intracranial aneurysm
acute onset of HA and sometimes neurological deficit
may missed on CT kaya dapat LP