Stroke Flashcards
What is the definition of stroke?
Sudden onset of impairment in neurological functioning due to severe decreased of blood supply to the brain
What is the definition of TIA?
Brief episode of neurologic dysfunction (typically < 1 hour) cause by focal brain ischemia but without evidence of infarct on brain imaging
What is a perinatal stroke?
Stroke between 20 wks of gestation and first 28 days of life
What is the cause of ischemic stroke?
Obstruction of blood flow at the site of occlusion (thrombus) or at a distance (embolus)
What circulation is most frequently affected by ischemic stroke (anterior or posterior)
Anterior, 80% of cases
More common in adults and children
Which type of stroke is more common in adults?
Ischemic
Which type of stroke is associated with higher mortality?
Hemorrhagic
Subarachnoid hem - 50% in first 6 months
What is the most common etiology for deep intracerebral hemorrhages?
Hypertension (50%)
What are two most common causes of stroke in young adults?
Aneurysms and anteriovenous malformations (AVMs, typically congenital)
ACoA aneurysm -most common cause of subarachnoid hem
Which type of stroke is most common in children?
Both are equally common
What are two major forms of infarction in children?
Arterial ischemic stroke (MCA most common) and sinovenous thrombosis (more common in neonates)
What is the critical time for neuronal damage in case of ischemia?
6-8 minutes of blood flow below critical levels
What is the critical time for recovery from ischemia?
6 hours, if blood flow is restored within that time, neurons surrounding ischemic penumbra may recover
What is the time window for TPA treatment?
3 hours
What are some consequences of hemorrhagic stroke?
Intracranial pressure and herniation
Which drug is associated with increased stroke risk?
Cocaine
What is the most common cause of intracranial hem in children?
Trauma
What are common risk factors of perinatal stroke?
Maternal infertility, preeclapmsia, prolonger membrane rupture, chorioamnionitis
Does the incidence of childhood stroke differ in boys and girls?
Yes, higher in boys
What is current mortality rate for stroke?
10% for ischemic and 25-35% for hem stroke
Which stroke is more commonly associated with LOC and coma?
Hemorrhagic
What infarct location is commonly associated with hemiparesis?
Superior MCA branch
What infarct location(s) are associated with visual field cuts?
Inferior MCA branch
PCA
What is the most common presentation of arterial ischemic stroke in childhood?
Seizures, then hemiparesis, AMS, and focal neurological signs
What infarct locations are associated with face and arm weakness?
MCA superior division (contralateral)
What type of aphasia is associated with left MCA stem infarct?
Global aphasia
What infarct location is associated with pure motor hemiparesi of the upper motor neuron type?
MCA deep territory (contralateral)
What infarct location is associated with constructional apraxia, neglect, and spatial difficulties?
Right MCA inferior division
What infarct location is associated with left weakness and transcortical aphasia?
Left ACA
What are deficits associated with left PCA stroke?
Right homonymous hemianopia
Alexia w/o agraphia with extension to the CC splenium
WHat neuroimaging method can detect infarct within minites from symptom onset?
Diffusion-weighted MRI
Is CT sensitive to acute intracerebral hem?
Yes
Is CT sensitive to ischemic damage?
Not in first 24 hours
What time frame is associated with most recovery post-stroke?
12 months, negatively accelerating course (greater btw 1-3 months, etc)
What is the prevalence of aphasia following LH stroke by hand preference?
99% in right-handers, 60-70% in left-handers
What is the triad of symptoms associated with ACoA hemorrhage?
Impaired episodic memory (Korsakoff-like), confabulation, and personality change
What is a vasospasm?
Acute narrowing of a cerebral vessel that reduces the blood flow and increases risk for stroke?
What is amyloid angiopathy hemorrahe?
Intracranial hem due to cerebral amyloid angiopathy or deposition of beta-amyloid in small and mid-sized arteries
What is brain herniation?
Life-threatening brain displacement from the central cranial vault through the tentorial notch or foramen magnum?
