Stroke Flashcards
Ischemic stroke stats
More likely in balcks than whites
Stroke is leading cause of adult disability
More mortality in females
Core and penumbra
Core- dead tissue most asosciated wiht impaired blood flow
Penumbra - tissue surrounding core is still viable but at risk of death
What occurs after injry?
First inijury response to prevent spread, then repair mechansims
Stroke syndromes (MCA)
ICA most common
If on left - aphasia
If on right - confusion and maybe apraxia/anosognosia
Both hemispheres - contral lateral arm, face>leg wekaness
Contra sensory dysfunction
Contra neglect
Differential for stroke
Get a head CT before doing anything else
MS Hysteria Conversion rxn Intoxicant TIA
TIA vs. storke
TIA Acute Rapid on, rapid off Short duration NO loss of consciousness
t-PA tx
Used 3-45 hours after onset of ischemic stroke (IV)
If given IA can be up to 8 hours
Risk of hemorrhagic transformation
t-PA contras
Recent ICH
Bledding diathesis
Severe unctorlled HTN
Serious head trauma in last 3 mos
Merci and penumbra timeline and disadv
Can be used up to 8 hours after stroke onset
May send distal emboli
Resources, expertise
Clot removal does not address secondary injury mechs
Outcome vs. clot removal
Morbidity has no increased with rate of ability to remove clots
Stroke tx
IV tPA - up to 4.5
IA tPA - up to 6
Mechanical thrombectomy - up to 8 hours
Stroke mostly kills ____ but also
Neurons
Glia and endothelium
Neurovascuar unit
Neurons connected to arteires and other supportive cells
If arteries affected, everything thrown off
Primary vs secondary injury
Primary - occlusion of the artery itself
Secondary - damage to the penumbra by apoptosis, ROS, etc.
Regeneration of blood vessels after stroke
Does not really happen efficienctly
Most blood vessels won’t actually have blood in them
Used for scaffolding
