stroke and hemorrhage Flashcards
If CSF has yellow color what can you expect?
Brain hemorrhage
Worst headache of my life?
saccular aneurysm
What are 2 types of stroke?
Occlusive/Ischemic- Artery occlusion
Hemorrhagic- compromised artery
True/False: With strokes size doesn’t matter.
True, location is what matters most
One of the diseases that the treatment is of upmost importance, we have been talking about. (Do something within 3 hours of it happening)
Stroke
The region surrounding the area of permanent tissue damage. This area will survive if you treat rapidly and appropriately.
Penumbra
Clot forms locally, over an atherosclerotic lesion.
Thrombotic stroke
Blockage by thrombi formed elsewhere. The thrombus detaches and travels and lodges in an artery.
Embolic stroke
Hypoxia due o insufficient blood supply.
Hypotension/hypovolemia.
Watershed infarct stroke
Subarachnoid hemorrhage, most common (aneurysm rupture, Arteriovenous malformation)
Hemorrhagic stroke
Most common causes of this hemorrhage is hypertension, arteriovenous malformation.
Intracerebral hemorrhage
Clinically stroke can be classified to 2 different classes, what are they?
Focal- particular area of brain is affected (due to artery occlusion or small hemorrhage)
Diffuse- the whole brain or multiple regions of the brain are affected. (patient usually unconscious)
LEads to decreased oxygenation of brain tissue (hypoxia) which can progress to tissue necrosis (infarction)
Ishemic
Rupture of a blood vessel.
Hemorrhagic
First thing we do when expecting stroke?
Order CT with and without contrast.
If pronounced headache associated with stroke symptoms it indicates what kind of stroke? (clinical pearl)
hemorrhagic stroke
True/False: Both ischemia and hemorrhage lead to virtually the same clinical presentation. The only difference is mechanism
True
Vascular event with symptoms similar to stroke.
Transient ischemic attack
What is the main difference between Transient ischemic attack and stroke?
TIA persist for only a few minutes to a few hours and pts usually fully recover.
What are clinically important because they ten to precede a stroke?
Transient ischemic attack
Ischemic infarction of the brain caused by a platelet thrombus that develops over a disrupted atherosclerotic plaque in a cerebral artery.
Thrombotic ischemic stroke
Thrombus has formed elsewhere detaches, travels to distal location where it lodges and occludes a vessel.
Embolic ischemic stroke
What are some sources of emboli?
LEft atrium
carotid arteries
__________ embolus is a venous embolus that passes through a patient foramen ovale and lodges in a cerebral artery.
Paradoxycal
Ischemic stroke findings, mechanisms of stroke?
swelling of brain (herniation)
Loss of demarcation between gray and white matter
Breakdown myelin
Glial cells react to the injury
What kind of stroke involves, contralateral hemiparesis and sensory loss mostly in face and upper extremity? (important)
Stroke involving MCA.
Wernicke’s aphasia is what?
due to MCA and is fluent, no sense
Brocas aphasia is what?
due to MCA and is not fluent and makes sense
If you have ISOLATED symptoms and pure motor and pure sensory, what type of stroke was it most likely?
Lacunar stroke
If patient has contralateral hemiparesis and sensory loss is predominantly in the LOWER extremity, and URINARY incontinence?
Anterior cerebral artery
If patient has vertigo and ataxia what is most likely the stroke?
Vertebral-basilar system
The vertebral-basilar system supplies what? SO its occlusion causes what?
LATERAL MEDULLA
lateral medullary syndrome, (WALLENBERG syndrome)
Strokes involving posterior cerebral artery has what main symptoms?
Visual field defects
“Eyes look towards the lesion”
Rupture of meningeal artery
Epidural
Rupture of a bridging vein
Subdural
Most often aneurysm rupture
Subarachnoid
“worst headache in my life”
Arterial bleed creates a blood filled space between bone and dura mater? Lens shaped.
Epidural hematoma
Rupture of bridging (emissary) veins between dura and arachnoid mater. Often seen in SHAKING BABY SYNDROME, ALCOHOLICS, elderly.
Subdural hematoma
Worst headache of my life and sudden onset.
Subarachnoid hemorrhage
What is most likely to have caused subarachnoid aneurysm?
berry aneurysm or arterial aneurysm
