Stroke Flashcards
what is ischemia?
decreased blood flow
reversible
what is infarction?
death of tissue due to lack of blood flow
a stroke results in a change in mental function for over ____ hours and evidence of ___ on imaging
24 hours
cerebral ischemia
T/F: there is evidence of ischemia/acute infarction on MRI after a TIA
F
how long does a TIA last?
usually <1 hours (15-20 mins)
can be up to <24 hours
after ____ hours of a TIA, there will be permanent damage
3
when is the risk of stroke highest after a TIA?
1st 30 days
what is the ABCD2 used for?
assess the risk of a stroke in the next 2 days after a TIA
components of the ABCD2
Age ≥ 60
Blood pressure ≥140 SBP or ≥90 DBP
Clinical features unilateral weakness or speech impairment w/o weakness
Duration: ≥ 60 mins (2 pts), 10-59 mins (1)
Diabetes
ABCD2 score:
high risk
moderate
low
high risk = 6-7
moderate = 4-5
low = 0-3
T/F: a sudden loss of consciousness should not happen during a stroke
T
what pattern of numbness is not indicative of a stroke?
both feet
one hand or one foot
stroke is the ___ leading cause of death in US and ____ globally
5th US
2nd global
what is one of the leading causes of serious disability in the US?
stroke
what is the most common ischemic stroke subtype?
undetermined etiology
how does paralysis of conjugate gaze present in an MCA stroke?
look towards lesion (away from weak side)
anterior MCA supplies _____’s area
posterior MCA supplies ____’s area
anterior = Broca’s
posterior = Wernicke’s
ACA stroke sx
LE hemiparesis & hemisensory loss
if bilateral = incontinence
slowness, lack of spontaneity
akinetic mutism (lack motivation)
what does an MCA stroke effect more?
UE and face
language areas
PCA stroke sx
cortical blindness
some contra sensory loss
inability to read
what is the most common cause of cardioembolic infarction?
atrial fibrillation
what are lacunar infarcts?
small infarcts of small penetrating vessels of the putamen, caudate, IC, pons, thalamus, corona radiata
lacunar infarcts are usually related to
diabetes and HTN
T/F: the face, arms, and legs are all effected equally with lacunar infarcts
T
where is the infarct in a pure motor stroke?
IC or base of pons
where is the infarct in pure sensory stroke?
posterolateral thalamus
where is the infarct in a sensorimotor lacunar stroke?
thalamus & IC
where is the infarct when a lacunar stroke causes dysarthria and clumsy hand syndrome?
base of pons
where is the infarct when lacunar stroke causes ataxia?
pons & IC or subcortex
sx of thalamus stroke
contra sensory loss to ALL modalities
spontaneous pain and dysesthesias
mild hemiparesis
lateral medullary syndrome (Wallenberg) is caused by what artery having ischemia?
PICA/vertebral
AICA stroke sx
hearing loss
facial weakness
ataxia
Horner’s
SCA stroke sx
ipsi ataxia
scanning speech
for every 30 min delay after stroke onset, there is a ___% decline in probability of good outcome
10%
the window for administering tPA is
4.5 hours
the window for an endovascular intervention is
24 hours
PT w/i ____ of tPA administration is contraindicated
24 hours
T/F: BP should be high after a stroke if no tPA is given
T
swelling up to _____ hours after stroke is normal
72 hours
if a stroke pt is worsening, how should the bed be positioned?
head of bed down/supine
when is the highest rate of recovery from a stroke?
1st 3-6 months
aggressive PT important
recovery from stroke begins ____ (proximal or distal)
proximally
if a pt was unresponsive, what type of stroke is suspected?
hemorrhagic
hemorrhagic strokes are usually due to
HTN
what must be done in order to differentiate ischemic vs hemorrhagic stroke?
CT
what are sx of increased intracranial pressure?
HA
vomit
decreased consciousness
common areas for intracerebral hemorrhage due to HTN
putamen
thalamus
cerebellum
(also hemisphere and pons)
what stroke is more deadly but has a better prognosis after 2 weeks?
intracerebral hemorrhage
what are most subarachnoid hemorrhages caused by?
rupture of intracranial aneurysm
how can a hemorrhage lead to an ischemic stroke?
vasospasms due to irritant of blood in areas not supposed to be
venous strokes are common with what conditions?
pregnancy/post-partum
OCP
lupus
stroke?
R hand weakness
mixing up words
loss of left eye vision
L carotid artery
stroke?
balance changes
veering towards right when walking
cerebellar
