stroke and hemorrhage

Question 1

If CSF has yellow color what can you expect?

Answer 1

Brain hemorrhage

Question 2

Worst headache of my life?

Answer 2

saccular aneurysm

Question 3

What are 2 types of stroke?

Answer 3

Occlusive/Ischemic- Artery occlusion

Hemorrhagic- compromised artery

Question 4

True/False: With strokes size doesn’t matter.

Answer 4

True, location is what matters most

Question 5

One of the diseases that the treatment is of upmost importance, we have been talking about. (Do something within 3 hours of it happening)

Answer 5

Stroke

Question 6

The region surrounding the area of permanent tissue damage. This area will survive if you treat rapidly and appropriately.

Answer 6

Penumbra

Question 7

Clot forms locally, over an atherosclerotic lesion.

Answer 7

Thrombotic stroke

Question 8

Blockage by thrombi formed elsewhere. The thrombus detaches and travels and lodges in an artery.

Answer 8

Embolic stroke

Question 9

Hypoxia due o insufficient blood supply.

Hypotension/hypovolemia.

Answer 9

Watershed infarct stroke

Question 10

Subarachnoid hemorrhage, most common (aneurysm rupture, Arteriovenous malformation)

Answer 10

Hemorrhagic stroke

Question 11

Most common causes of this hemorrhage is hypertension, arteriovenous malformation.

Answer 11

Intracerebral hemorrhage

Question 12

Clinically stroke can be classified to 2 different classes, what are they?

Answer 12

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)

Question 13

LEads to decreased oxygenation of brain tissue (hypoxia) which can progress to tissue necrosis (infarction)

Answer 13

Ishemic

Question 14

Rupture of a blood vessel.

Answer 14

Hemorrhagic

Question 15

First thing we do when expecting stroke?

Answer 15

Order CT with and without contrast.

Question 16

If pronounced headache associated with stroke symptoms it indicates what kind of stroke? (clinical pearl)

Answer 16

hemorrhagic stroke

Question 17

True/False: Both ischemia and hemorrhage lead to virtually the same clinical presentation. The only difference is mechanism

Answer 17

True

Question 18

Vascular event with symptoms similar to stroke.

Answer 18

Transient ischemic attack

Question 19

What is the main difference between Transient ischemic attack and stroke?

Answer 19

TIA persist for only a few minutes to a few hours and pts usually fully recover.

Question 20

What are clinically important because they ten to precede a stroke?

Answer 20

Transient ischemic attack

Question 21

Ischemic infarction of the brain caused by a platelet thrombus that develops over a disrupted atherosclerotic plaque in a cerebral artery.

Answer 21

Thrombotic ischemic stroke

Question 22

Thrombus has formed elsewhere detaches, travels to distal location where it lodges and occludes a vessel.

Answer 22

Embolic ischemic stroke

Question 23

What are some sources of emboli?

Answer 23

LEft atrium

carotid arteries

Question 24

__________ embolus is a venous embolus that passes through a patient foramen ovale and lodges in a cerebral artery.

Answer 24

Paradoxycal

Question 25

Ischemic stroke findings, mechanisms of stroke?

Answer 25

swelling of brain (herniation) Loss of demarcation between gray and white matter Breakdown myelin Glial cells react to the injury

Question 26

What kind of stroke involves, contralateral hemiparesis and sensory loss mostly in face and upper extremity? (important)

Answer 26

Stroke involving MCA.

Question 27

Wernicke's aphasia is what?

Answer 27

due to MCA and is fluent, no sense

Question 28

Brocas aphasia is what?

Answer 28

due to MCA and is not fluent and makes sense

Question 29

If you have ISOLATED symptoms and pure motor and pure sensory, what type of stroke was it most likely?

Answer 29

Lacunar stroke

Question 30

If patient has contralateral hemiparesis and sensory loss is predominantly in the LOWER extremity, and URINARY incontinence?

Answer 30

Anterior cerebral artery

Question 31

If patient has vertigo and ataxia what is most likely the stroke?

Answer 31

Vertebral-basilar system

Question 32

The vertebral-basilar system supplies what? SO its occlusion causes what?

Answer 32

LATERAL MEDULLA | lateral medullary syndrome, (WALLENBERG syndrome)

Question 33

Strokes involving posterior cerebral artery has what main symptoms?

Answer 33

Visual field defects | "Eyes look towards the lesion"

Question 34

Rupture of meningeal artery

Answer 34

Epidural

Question 35

Rupture of a bridging vein

Answer 35

Subdural

Question 36

Most often aneurysm rupture

Answer 36

Subarachnoid | "worst headache in my life"

Question 37

Arterial bleed creates a blood filled space between bone and dura mater? Lens shaped.

Answer 37

Epidural hematoma

Question 38

Rupture of bridging (emissary) veins between dura and arachnoid mater. Often seen in SHAKING BABY SYNDROME, ALCOHOLICS, elderly.

Answer 38

Subdural hematoma

Question 39

Worst headache of my life and sudden onset.

Answer 39

Subarachnoid hemorrhage

Question 40

What is most likely to have caused subarachnoid aneurysm?

Answer 40

berry aneurysm or arterial aneurysm