Stroke and Hemorrhage

Question 1

Infarct

Answer 1

necrotic region of tissue

Question 2

Stroke

Answer 2

abrupt incident of vascular insufficiency resulting in loss of neurologic function

Question 3

Occlusive (Ischemic) Stroke

Answer 3

70- 80%
Thrombotic and Embolic
reduced blood supply leads to hypoxia which can lead to tissue death (infarction)

Question 4

Hemorrhagic Stroke

Answer 4

not due to trauma
Intracranial and Subarachnoid Hemorrhages
rupture of vessel

Question 5

Penumbra

Answer 5

region surrounding area of permanent tissue damage
will survive if treated quickly
3 hours to treat

Question 6

Thrombotic Stroke

Answer 6

clots form locally over atherosclerotic lesion

has prodromes- vasospasms and partial occlusion- transient ischemic attack

Question 7

Embolic Stroke

Answer 7

thrombus detaches and lodges in artery

no prodromes

Question 8

Watershed Infarct

Answer 8

hypoxia due to insufficient blood supply
hypotension
affects vulnerable sites

Question 9

Causes of Subarachnoid Hemorrhage

Answer 9

aneurysm rupture

arteriovenous malformation

Question 10

Causes of Intracerebral Hemorrhage

Answer 10

hypertension

arteriovenous malformation

Question 11

Focal

Answer 11

due to artery occlusion or small hemorrhage
certain area of brain is affected
neural deficits at multiple sites

Question 12

Diffuse

Answer 12

whole or multiple parts of brain are affected

patient normally unconscious

Question 13

Hemorrhage in Parenchyma

Answer 13

rupture of small artery

leads to accumulation of blood within brain and compression of adjacent tissue

Question 14

Hemorrhage in Subarachnoid Space

Answer 14

rupture of superficial artery

blood compresses brain underneath

Question 15

Transient Ischemic Attack

Answer 15

vascular attack w/ symptoms similar to stroke
deficits only last for a few minutes
monocular blindness
often precede stroke

Question 16

Sources of Emboli

Answer 16

left atrium of heart
carotid arteries
paradoxycal- venous embolus, cerebral artery

Question 17

Locations of Ischemic Stroke

Answer 17

MCA
Internal Carotid near bifurcation
Basilar A

Question 18

Ischemic Stroke Effects

Answer 18

brain swelling
myelin breakdown
demarcation b/t gray and white matter

Question 19

Gliosis

Answer 19

reaction to injury
microglial cells remove necrotic tissue
astrocytes proliferate at margins of infarct
cystic area develops
necrosis of brain tissue

Question 20

Strokes involving MCA

Answer 20

sensory loss in face and upper extremity

pure motor, pure sensory, and isolated symptoms- monoparesis and isolated sensory loss

Question 21

Strokes involving ACA

Answer 21

contralateral hemiparesis and sensory loss in lower extremity
urinary incontinence

Question 22

Strokes involving Vertebral Basilar System

Answer 22

Vertigo and Ataxia

Question 23

Posterior Inferior Cerebellar Artery supplies….

PICA

Answer 23

lateral medulla

occlusion causes Wallenberg syndrome

Question 24

Strokes involving Posterior Cerebral Artery

Answer 24

gaze paralysis- 3 nerve palsy
Visual Field Defects- eyes look toward lesion
Contralateral sensory loss

Question 25

Intracranial Hematoma

Epidural

Answer 25

rupture of meningeal artery

blow to head

Question 26

Intracranial Hematoma

Subdural

Answer 26

rupture of bridging vein

accident- head hits hard surface and brain moves abruptly in skull

Question 27

Intracranial Hematoma

Subarachnoid

Answer 27

worst headache of my life
ruptured berry aneurysm
CN3 paralysis