Stroke

Question 1

Transient Ischemia Attack (TIA) vs. Stroke

Answer 1

TIA is transient neuro dysfunction from focal ischemia w/out acute infarction (tissue death)

Question 2

Worldwide Stroke Burden

Answer 2

Highest stroke incidence/new cases in low-middle income countries, highest prevalence in developed nations

Question 3

Stroke Incidence Race/Gender

Answer 3

B and H have higher than W

Men have higher incidence, but more older women so more stroke cases are actually women

Question 4

2 Main Types of Stroke

Answer 4

Ischemic - 80%

Hemorrhagic - 20%

Question 5

2 Kinds of Hemorrhagic Strokes

Answer 5

Intracerebral hemorrhage (60%, substance of brain, small b.v.s)
Subarachnoid Hemorrhage (40%, aneurysm bursts causing bleeding along surface)

Question 6

4 Kinds of Ischemic Stroke

Answer 6

Atherthrombotic Cerebrovascular Disease (20%)
Lacunar (25%, small vessel disease)
Embolism (20%)
Cryptogenic (30%, unknown)

Question 7

ESUS

Answer 7

Embolic stroke of undetermined source

Question 8

3 Treatment for SAH

Answer 8

Reduce rebleeding risk w/ early surgical clipping or endovascular coiling
Reduce delayed ischemia
Reduce hydrocephalus (ventriculostomy)

Question 9

2 Main Causes of Intracerebral Hemorrhage (and major sign)

Answer 9

Focal problems more common
Hypertension -> small vessel disease
Amyloid Angiopathy

Question 10

2 Treatment for Intracerebral Hemorrhage

Answer 10

BP control
Reduce bleeding (reverse anticoags)

Question 11

6 Infarct Subtype Classifications

Answer 11

Extracranial artherosclerotic (EATH)
Intracranial artherosclerotic (IATH)
Lacunar small vessel (LAC)
Cardioembolic (CEMB)
Conflicting mech (CONF)
Cryptogenic (CRYPT)

Question 12

4 Requirements for Ischemic Stroke Workup

Answer 12

Brain imaging: Head CT/MRI
Extracranial vascular imaging: Carotid doppler/angiogram and shit
Intracranial vascular imaging
Cardiac assessment

Question 13

2 Mechs for Artherosclerosis Cerebral Infarction

Answer 13

Hemodynamic - fluid failure

Embolism - a. 2 a.

Question 14

Atrial Fibrillation

Answer 14

Most common arrythmia, common cause of cardiac embolism -> cerebral infarction

Question 15

Brain Image of Small Vessel Disease -> Cerebral Infarction

Answer 15

Focal, deep infarct sparing surface

Question 16

TPA

Answer 16

Clot buster that needs to be administered w/in 1-4.5 hrs