Stroke guidelines Flashcards
Stroke syndrome that involves contra lateral weakness of the leg > arm
Anterior cetebral artery syndrome
Stroke syndrome that involves arm, face, upper and lower extremity more than the leg?
MCA syndrome
In MCA stroke preferential gaze is to what side of the lesion?
Ipsilateral side
Homonimous-hemianopsia with macular sparing is found in what stroke syndrome?
Part of MCA syndrome
What division of the MCA is affected for expressive aphasia or Bocas aphasia?
MCA superior division
Receptive aphasia is found in what division of MCA syndrome?
Inferior MCA
In MCA syndrome global aphasia is noted when what side is affected?
Dominant side
Agnosia, constructional apraxia, is present when the dominant part of the MCA territory is affected? True or false?
False. Non dominant side
Px who cannot calculate, cannot Wright, cannot identify fingers, with left tor right confusion has what type of store syndrome?
Gertsman Syndrome
Affecting the dominant hemisphere of the MCA with partial occlusion
Denial Blindness is seen in what stroke syndrome?
Antons Syndrome
Bilateral PCA stroke
Contralteral weakness with ipsilateral CN 3 deficit
Webber syndrome of the PCA
Contrlaeral rubral tremor (wing flapping) tremor
Claudes syndrome
Ipsilateral cerebellar ataxia with contralteral weakness
Anterior Inferior cerebellar artery
Maeie-Foix syndrome
Vical cord paralysis, dysphagia, dysarthria, hiccups
Posterior inferior cerebellar artery syndrome or wallendburg syndrome
Locked in syndrome
Found in basilar artery syndrome
Top 5 stoke mimics
Seizure Infections Tumor Toxicity Positional vertigo
Strongest risk factor for stroke among Filipinos
Hypertension
Most prevalent risk factor for atherothrombosis
Smoking
For primary stroke prevention regular screening shoud be done for hypertension at least every how many years?
Every 2 years
Target A1c level for diabetic pxs with stroke
<7%
To reduce stroke the target BP for pxs with DM shoud be?
<130/80
For MI patients in order to prevent stroke oral anticoagulants are needed for the following risk factors
Persistent AF
Decreased EF
LV thrombosis detected
Stroke pxs with LV mural thrombosis should have anticoagulants whatbisnthe target inr and duration?
InR 2-3
For at least 3 months to one year
Pxs with rheumatic mitral valve disease or prosthetic heart valves need anticoagulants unless contraindicated
True
When do you give aspirin in pxs with warfarin therapy?
For pxs with recurrence of embolism with or without AF
For patients with AF who cannot take oral anticoagulants, what is the class 1a evidence drug alternative?
Aspirin at 325mg/ day
For pxs with very high risk factors target ldl according to stroke guidelines is?
<70 mg/dl
Mass screening for carotid artery stenosis is recommended? True or false
False
Not cost effective
CEA ( Carotid Endaraterectomy) is a class 1 indication for?
- Symptomatic stenosis of >60%, life expectancy atleast 5 years, perioperative risk is <6%
- TIA or stroke, ipsilateral carotid stenosis of 70-99%, perioperative risk <6%
- Symptomatic patients with 50-69% carotid stenosis depending on px specific factors and initial symptoms
For patients with ischemic stroke or TIA is screening for intracranial stenosis recommended?
Yes
Medication used for prevention of progession of intracranial artery stenosis?
Aspirin + cilostazol
What is the formula for Maximum hear rate?
220-age
For secondary prevention of stroke
50-60% of maximal heart rate is beneficial
Moderate intensity exercise is defined as?
Scale of 5 or 6 / 10 on relative scale
3.0-5.9 on absolute scale
High in tensity is 6.0 or more on absolute scale
And 7-8/10 on relative scale
Recommended
Peak oxygen uptake?
Maximal heart rate?
Heart rate reserve?
For stroke survivors on aerobic exercises
Peak O2 and heart rate reserve - 40-70%
Maximal heart rate 50-80%
Recommended frequency and duration of aerobic exercises for stroke survivors?
3-7 days/ wk
20-60 minute duration
Resistance training for stroke patients recommendation?
1-3 sets
10-15 reps
8-10 exercises involving large muscle groups
BMI recommended for stroke prevention?
Waist to Hip ration?
Waist circumference?
18.5-24.9 BMI
- 0 in men
- 85 in women
35 inches in men
31 inches in women
Recommended salt intake for stroke patients?
< 2.4 g/day
Potassium 4.7 g/day
Iosilateral CN6 palsy, with contralateral plegia
Raymond syndrome
Pontine stroke paramedian branches
CN 6 and 7 palsy with contralateral plegia
Millard-Gubler syndrome
CN 12 palsy, contralteral plegia, loss of vibration sense, position sense pain
Dejerine
Vertebral artery
Medullary stroke type
