Stroke Flashcards
Cause of a subdural hematoma/haemorrhage
Venous bleeding from stretched, torn cerebral bridging veins entering the superior sagittal sinus as a result of head trauma
Cause of a subarachnoid hemorrhage
Typically a ruptured berry aneurysm aneurysm in a vessel supplying or around the circle of Willis
Head trauma also
Subdural hematoma appearance on a CT scan
Crescent shaped
lighter area - acute hematoma
darker area - chronic hematoma
Cause of an epidural hemorrhage
Injuries to the meningeal arteries, commonly the middle meningeal artery (75%) due to head trauma (contact sports)
Epidural hemorrhage appearance on a CT scan
Bi-convex shape
Wernicke’s area location & function
temporal lobe
comprehension of language
Broca’s area location & function
frontal lobe
production of language (speech, sign language)
Diagnosis for strokes
CT scan (within an hour) - identify any bleeding/rule out
Angiography - locate a blood clot
Flair MRI - can distinuish a new stroke from an old one
Treatment for ischemic stroke
Thrombolysis - break up clot with an enzyme (TPA); clot busting drug delivered to site through catheter
Thrombectomy - (mechanical) push a wire into the clot and physically pull it out or (suction) break up the clot and suck it out through the catheter
Aspirin - prevents platelets forming more clots
thrombolysis must be used within what time limit
within 4.5 hours of symptom onset
Enzyme used in thrombolysis
Tissue plasminogen activator (TPA)
thrombectomy must be used within what time limit
within 6 hours of symptom onset
Treatment for hemorrhagic stroke
Anti-hypertensives - lower BP
Craniotomy (epi- & subdural)
Drain blood with catheter (through hole in skull) (subdural)
Surgery to clip bleeding artery (subarachnoid -caused by aneurysm remember)
subarachnoid hemorrhage symptom
thunderclap headache
Where is the bleeding in an epidural haemorrhage?
bleeding into the space between the dura mater and the skull
