Stroke CC2 Flashcards
most ischemic strokes are of ___ etiology
embolic (33%)
30% are large vessel
20% are small vessel
___% of strokes are ischemic
83
__% of strokes are intracerebral hemorrhage
10
__% of strokes are subarchnoid hemorrhages
7
1 risk factor for strokes is
high bp
nonmodifiable risk factors for stroke
age, sex, family history
stroke mimics include (5)
- hypoglycemia
- mass lesions
- seizures/postictal states
- migraine
- psychogenic hemiparesis
contralateral hemiparesis (weakness on one side of the body) suggests ___ stroke
MCA
sx of anterior division MCA stroke
contralateral head & eye deviation
sx of posterior division MCA stroke
hemianopsia (contralateral visual field deficit),
is ____ is occluded on the right side, what sx do you get neglect
posterior division MCA
leg and foot deficits seen with
ACA stroke
what could cause cortical blindness
bilateral PCA stroke
what is hemihypaesthesia? with what artery occlusion do you see it?
complete loss of sensation of the contralateral face, arm, trunk and leg
seen with PCA
signs of basialr/brainstem stroke
altered consciousness & crossed signs:
cranial nerve deficit on one
side
hemiparesis or sensation loss of body on other side
loss of perfusion to internal capsule by lenticulostriate causes __ sx
pure motor hemiplegia (whole
side)
loss of perfusion to thalamus by lenticulostriate causes __ sx
pure sensory hypaesthesia (whole side)
loss of perfusion to pons by lenticulostriate causes __ sx
dysarthria, clumsy hand syndrome
what do you use to rule out hemorrhage?
ct scan (shows up white)
early infarct signs on a ct
- hypodensity of grey or white matter
- obliteration of cortical sulci
- obscured basal ganglia
- loss of insular ribbon
aphasia indicates ___
L. hemispheric stroke
neglect / hemi-inattention indicates
R. hemispheric stroke
patients usually look ___ the lesion
toward
crossed signs –> ___ involvement
brainstem
vertigo of central origin usu. means
other cranial nerve deficits
vertical nystagmus is brainstem ____ until proven otherwise
ischemia
tPA Indications and Contraindications Inculsion if: age___
less than 80
tPA Indications and Contraindications Inculsion if: onset is
less than 3 hours
tPA Indications and Contraindications Inculsion if: NIHSS ___
less than 24
tPA Indications and Contraindications Inculsion if: ___ consent
informed
tPA Indications and Contraindications EXCLUSION if: (danger zone)
- CT signs of hemorrhage or very large infarction
- undetermined time of onset
- uncontrollable hypertension or blood sugar
- recent trauma, major surgery or bleeding
- abnormal coagulation profile
- hemodynamic compromise from MI - rapidly resolving deficit
tPA Risks and Benefits: treatment group had ___% more patients rated at “good outcome” after 3 months.
30
risk of hemorrhage was __% with tPA treatment (1% without)
6
hemorrhage after tpa –> __% mortality rate
50
secondary risk prevention includes control of modifiable risk factors like
HTN, diabetes, CAD, obesity
___ new or recurrent strokes each year.
600,000
in terms of RR, which is the #1 risk factor of stroke
a. fib
__ stenosis is a risk factor of stroke
carotid
most common area affected by hemiparesis with right MCA stroke?
face=hand > arm > leg
lacunar syndromes involves
pure motor hemiplegia from damage to the internal cpasule
???
subarahnoid hemorrhage
subdural hematoma
what is this??
hyperdense MCA sign
early dx of stroke?
an appearance of increased attenuation of the proximal middle cerebral artery (MCA) that is often associated with thrombosis of the M1 MCA segment
