Stroke Flashcards
2 types of stroke
Ischemic (80%) - thrombosis, embolic, hypoperfusion
Hemorrhagic (20%) - multiple types
TIA definition
stroke-like symptoms that resolve in under 24 hours
Neurological episode that resolves and MRI negative
10% have full stroke in 90 days
RF of thrombolic stroke
HTN CAD DM Vascular disease Sickle cell smoking age
RF of embolic stroke
A-fib *** CHF PFO Valve replacement MI age
Prevention of stroke
Primary - RFs
Secondary - plavix, coumadin, factor Xa inh
DDX of stroke SX
Seizure Hypoglycemia Metabolic disorder Encephalopathy Brain lesion Sepsis Medication Spinal cord issues
S/SX of stroke
one side weakness/numbness Speech, thought motion issues Balance problems HA Seizure Visual changes LOC - not syncope
Rule out…
Blood sugar
Narcotics
Vitals
ER procedure
Take vitals/stabilize Quick H/P Immediate head CT** Basic labs/coags EKG
Only widely used TX of acute ischemic stroke
Thrombolytics - tPA
Use of anticoagulants
Used to PREVENT primary/secondary stroke
Not used in acute stroke - risk of bleed (3-7 post stroke)
How to qualify for tPA
normal CT
Within 3 hours from last known normal
Cannot have bleed, tumor, mass effect stroke, brain swelling, resolving SX
Most common area of stroke
Posterior area of internal capsule
Opposite paralysis
Opposite lower face paralysis (Bells has forehead involvement)
Frequent cause of IS in young adults
Meth (5X)
Cocaine (2X)
Stroke patient in podiatry office
Call 911 Check sugars Start IV Talk to ER doc Send records Educate patient
