Stroke Flashcards
Types of Stroke
- Ischemic
- Hemorrhagic
Transient ischemic attack
- Transient episode, symptoms last < 24 hrs
- focal ischemia, without acute infarction
Subarachnoid hemorrhage (SAH)
- Bleeding between the arachnoid and pia mater (CSF filled space)
- Commonly-rupture of a cerebral aneurysm
- “Worst headache of one’s life”
- Stiff neck
Types of ischemic strokes?
thrombolic, embolic, and watershed
Stroke-Clinical Manifestations
- Face, Arm, Speech, Time
- Motor/Sensory changes
- Communications
- Personality/Affect
- Intellectual function
- Spatial-perceptual alterations
- Elimination
Common quick check of stroke manifestations?
(FAST) Face - doopage, asymmetrical Arm - weakness Speech - slurred Time - tx quickly
Stroke risk factors?
HTN, a-fib, MI, high cholesterol, smoking
Medical tx for a patient with a hx of TIA?
- Antiplatelet drugs (Aspirin, Ticlopidine, Clopidigrel)
- Warfarin (atrial fib)
- Surgical Intervention
- Carotid endarterectomy
are around stroke site with limited blood flow that can saved with quick tx?
penumbra
What is the tx focus for ischemic stroke?
clot busters and to prevent new clot formation
What is the tx focus for hemorrhagic stroke?
manage symptoms and complications (anti-HTN, anti-convulsants)
Ischemic stroke medications?
- Aspirin
- platelet inhibitors and anticoagulants
- tPA
How long after a stroke should aspirin be given?
within 24 - 48 hrs
How long after a stroke should tPA be given?
- within 3 - 4.5 hrs
- interarterial within 6 hrs of onset
Surgical interventions for ischemic stroke?
clot retrieval (MERCI or suction)
Surgical interventions for Hemorrhagic stroke?
Clipping and Coiling
Subarachnoid Hemorrhage Treatment?
- Prevent rebleed
- Clipping
- Coiling
- Manage ICP
- Treat cerebral vasospasm
- Nimodipine
- Manage HTN and Seizures
What drug is given to treat cerebral vasospasm during a subarachnoid hemorrhage?
Nimodipine- dihydorpyridine CCB relaxes vascular smooth muscle causing vasodilation
What is homonymous hemianopia?
blindness in same half of of each visual field
Medical term for drooping eyelid(s)?
ptosis
Manifestations of Right-brain stroke?
- left hemiplegia
- Difficulty in judging position, distance, and movement
- Impulsive, impatient, and deny problems related to stroke
- short attention span
- Respond best to directions given verbally
Manifestations of Left brain stroke?
- Right hemiplegia
- Slower in organization and performance of tasks
- Impaired spatial discrimination
- Impaired speech/language aphasias
- Have fearful, anxious response to stroke
- Respond well to nonverbal cues
