Stroke Flashcards
What are the types of strokes?
- Embolic 2. Thrombotic (involves diseased vessels) 3. Hemorrhagic (subarachnoid or parenchymal)
ACA feeds primarily
Feet and legs
MCA feeds primarily
Arms, hands, face, speech
PCA feeds primarily
vision
Basilar and vertebral insufficiency leads to
Syncope
Basilar infarct can lead to what syndrome?
Locked in syndrome
What are signs of cerebellar infarct?
Dysdiadokinesia; Ataxia
Why perform a non-contrast CT of the head?
Answers the question, “is this a brain bleed?”
If a hemorrhagic stroke is diagnosed on CT, what are the neurosurgical options?
Clip Coil Craniotomy
While waiting for neurosurgery to consult on a hemorrhagic stroke, what is your role?
Reduce BP; Control bleed with FFP
After acute management of a stoke, what studies should be ordered?
EKG Echo Carotid Ultrasound
What post stroke finding requires a heparin to warfarin bridge?
Thrombus found on echo
What post stroke finding does not require a heparin to warfarin bridge?
Atrial fibrillation
Stroke is a clinical diagnosis. If there is a question, order what study?
MRI
What is the cutoff time for tPA?
3 hours from symptom onset
What is the BP cutoff for tPA?
<180/<105
Who can’t you tPA
Anyone with current bleed, like GI bleed; Anyone with hx of intracranial bleed; Anyone with recent surgery
Do not give what blood thinner in an acute stroke setting?
Heparin Warfarin
Why allow permissive BP in the setting of acute stroke management (w/o tPA)?
Up to 220/110; Allowing punumbra (area around the infarct) to be perfused
What is the management of diabetes in the setting of acute stroke?
Tightly control sugar, <140
If a patient has a stroke while on aspirin, what is the management in terms of antiplatelet therapy in the long term?
ASA + dipyrimidole OR clopidogrel for ASA intolerance
