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Neuro > Stroke, hemorrhage, cerebrovascular diseases > Flashcards

Stroke, hemorrhage, cerebrovascular diseases Flashcards

1
Q

Types of strokes

A
  • Hemorragic (subarachnoid hemorrhage, intracerebral hemorrage)
  • Ischaemic (atherosclerosis, small vessel disease, cardioembolism, rare causes, criptogenic)
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2
Q

Consecuentes of parenchymal hemorrage

A

Increases in IP: secondary brainstem hemorrhage of Duret, pathomorphological confirmation of brain death
HErniations: subfalcine, transtentorial, tonsilar

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3
Q

Subarachoid hemorrage clinical feature

A

Sudden severe headache
Vomiting
Neck stiffness (rigidez en el cuello)
Consciousness disturbances
Xantochromatic CSF

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4
Q

Increased intracranial pressure causes

A

Bleeding
Impaired circulation
Brain edema

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5
Q

Increased intracranial pressure consequences

A

Decresed cerebral perfusion pressure
Preretinal bleeding
Brain herniation
Hydrocephalus

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6
Q

Clinical presentation of subarachnoid hemorrage

A

Sudden, worst headache which doesn’t go away
Vomiting
Disturbance of consciousness
Meningeal signs
Rarely focal neurological dysfunction

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7
Q

Recognizing acute ischemic stroke

A

Sudden onset of symptoms and signs
Typical clinical signs: MCA, ACA, PCA, POCA, AICA syndromes
Improvement of clinical symptoms and sigs in less than a day
Patients can have:
-homonymous visual defect in field opposite involved artery
- Language defect when dominant hemisphere involved
- hemiparesis or the side opposite involved artery
- patient may awaken from sleep unable to move affected side

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8
Q

Endovascular treatment for AIS

A

Blood vessel
Blood clot
Stent

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9
Q

Patients with stroke and AF are prescribed

A

New coagulant drugs
Varfarine treatment

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10
Q

Intracerebral haemorrhage

A

Sudden devastating presentation
Rupture of a vessel: development of hematoma–> focal clinical deficit, deterioration of conscious level secondary of mass effect.

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11
Q

Patient in coma with vomiting and/or neck stiffness are more likely to have

A

Intracerebral hemorrhage than ischemic stroke

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12
Q

Causes of intracerebral hemorrhage

A

Hypertensive small vessel disease
Anticoagulants
Amyloid angiopathy
Arteriovenous malformation
Aneurysm

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13
Q

Thalamic haemorrage produces

A

sensory change in the contralateral limbs

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14
Q

Putaminal haemorrage produces

A

contralateral hemiparesis and conjugate deviation of the eye towards the side of the hematoma

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15
Q

Lobar haemorrage produces in frontal lobe

A

eye deviation
Contralateral hemiparesis

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16
Q

Lobar haemorrage produces in the central region

A

hemisensory loss
dysphasia in the dominant hemisphere

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17
Q

Lobar haemorrage produces in the parietal ole

A

Hemisensory loss
neglect or innatention

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18
Q

Lobar haemorrage produces in temporal lobe

A

Fluent dysphasia with poor comprehension, secondary ro damage of Wernicke

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19
Q

Pontine haemorrage produces

A

Coma with pinpoint pupils
Loss of horizontal eye movement
Quadriparesis

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20
Q

Intraventricular haemorrhage produces

A

Headache
Vomiting
Neck stiffness
Depression of consciousness

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21
Q

Treatment of intracranial aneurism

A

Embolisations with coils
Flow diverter stents

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22
Q

Arteriovenous malformations and fistulas treatment

A

Embolisation with liquid agent (Onyx)

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23
Q

Drug used for prevention of stroke

A

Arterial thrombosis: antiplatelet drugs (aspirin)
Venous thrombosis: anticoagulant drugs (warfarin)

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24
Q

Drugs that affect coagulation cascade

A

Heparin (binds to antithrombin III and accelerates its binding to thrombin and factor Xa and prevent fibrin formation)
Warfarin (Antagonizes cofactor function of fit K and so affect factors II, VII, IX, X)

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25
Q

Causes of TIA (transient ischemic attack)

A

Trombotic or embolic
Small vessel disease
Cardioembolism
arterial disección or hypercoagulability
Cryptpgenic TIA/stroke

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25
Q

TIA

A

Transient neurological condition due to focal cerebral, spinal cord or retinal ischemia without acute infarction. Lasting up to 24h

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26
Q

Symptoms of TIA

A

Focal neurological deficit or monocular visual disturbance
Sudden onset. Maximal at onset
Focal insufficiency of cerebral blood flow
Lasting up to 24h

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27
Q

Patient with sudden pain on the left side of the neck, miosis of left pupil and ptosis of the left eyelid and hemiplegia on the right side. Cause

A

Dissection of the internal carotid artery

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28
Q

Most common location of hypertensive brain haemorrhage

A

Basal ganglia and thalamus

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29
Q

Test to confirm temporal arteritis

A

temporal arteritis biopsy

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30
Q

Temporal arteritis can be accompined by

A

rheumatic polymyalgia

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31
Q

Therapy for temporal arteritis

A

corticoesteroids

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32
Q

Right occipital headache after exercise. Her sister had breast carcinoma. Dysarthria, nystagmus, ataxia

A

Atherosclerotic cerebellar stroke

33
Q

Antihypertensives succesful in secondary stroke prevention

A

ACE inhibitors

34
Q

Patient with paraplegia, treated for hypertension and lipids, no sensory loss around her belly button

A

Spinal cord infarction

35
Q

treatment in a patient with deep vein thrombosis with motor paresis after stroke

A

Low molecular weight heparin

36
Q

The day after thrombolysis for stroke the patient is given

A

Aspirin, dipyridamole, statins, hypertensives

37
Q

26 years old sudden headache, vomiting, slowly losing consciousness type of hemorrhage

A

Subarachnoid hemorrhage

38
Q

Sudden hard headache, neck stiffness, vomiting without fever

A

subarachnoid hemorrhage

39
Q

How long does a TIA usually last

A

20 min

40
Q

temporal arteritis treatment

A

Methylprednisolone

41
Q

Dull pain on the left side of head, radiating a little to the right. No nausea or vomiting, anemia

A

Temporal arteritis

42
Q

Common location of lacunar ischaemic stroke

A

Internal capsule

43
Q

Most common mechanism of cerebellar damage in penumbra

A

Excitotoxity

44
Q

Gigantocellular temporal arteritis

A

Increased SR

45
Q

Wallenberg syndrome which artery is affected

A

Vertebral artery o posterior inferior cerebellar artery (PICA)

46
Q

Wallenberg syndrome damage in

A

Medulla oblongata

47
Q

Wallenberg syndrome. CLinical

A

Contralateral body hyposthesia
Ipsilateral facial hyposthesia
Nauseas, vomiting
Disartria, disfagia
Horner’s syndrome
Ipsilateral ataxia
No pyramidal or XII afectation

48
Q

Speech disorder if ACM stroke

A

Aphasia

49
Q

67 years old, dizziness, vomiting, nystagmus of grade 3 with rapid phase to the left, does not change direction when moving, little rotatory movement

A

Cerebellar infarction

50
Q

22 years old fallen, unresponsive, looking to the right, waving her right arm, where is the damage

A

Right frontal lobe

51
Q

Systemic vasculitis treatment

A

corticosteroids

52
Q

CHA2 DS2-VASc is a scale for

A

risk of ischaemic stroke in patients with atrial fibrillation

53
Q

Intracerebral hemorrhage

A

Abrupt onset, usually after exercise, headache, vomiting, progressive and fast loss of conscious

54
Q

Cardiac patient after catheterisation with loss of sensation on the left side of the body and face damage in

A

Thalamus

55
Q

Ischaemia critical for neurons occurs when cerebral blood flow is reduced to

A

10ml/100g/min

56
Q

Cerebellar damage in ischaemic stroke has a pith where

A

cells are more severely affected

57
Q

Cerebellar damage in ischaemic stroke has penembra where

A

cells are less severely affected

58
Q

Most common location of intracerebral haemorrhage

A

thalamus and striatum

59
Q

most important risk factor for stroke

A

arterial hypertension

60
Q

treatment on the day after TIA in a patient with symptomatic carotid disease

A

high-dose statin, clopidogrel, antithypertensive until blood pressure is reduced to 139/85 mmHg

61
Q

Sudden onset motor aphasia and right limb hemiparesis

A

Cardioembolic ischaemic stroke

62
Q

Noise above the carotid artey will be

A

TIA

63
Q

Sudden right limb hemiparesis, arms more affected than legs, unable to speak. Where is the lesion

A

left cerebral media artery

64
Q

Consequence of a patient that felt and tore his meningea media artery

A

epidural haematom a

65
Q

Right patient with infarction in the area of cerebral media artery on the right, desviation of the view to the

A

right

66
Q

Right patient with infarction in the area of cerebral media artery on the right, hemiparesis on the

A

left

67
Q

In neglet syndrome in which hemisphere are lesion and what happen

A

non-dominant hemisphere, deficit in the contralateral side of the lesion stimulus

68
Q

how to remove large thrombus in cerebral veins

A

intra-arterial with mciro-tools

69
Q

Long-term consequence of lacunar strokes

A

Dementia

70
Q

Is bleeding common in the mesencephalon?

A

No

71
Q

Lacunar stroke symptoms

A

right hemiparesis and dysarthria

72
Q

Test for intracranial aneurysm

A

CT angiography

73
Q

most sensitive test for intracranial aneurysm

A

digital substraction angiography

74
Q

Cerebral artery is most commonly involved in aneurysms

A

cerebral artery

75
Q

Treatment for obstructive hydrocephalus after SAC

A

external ventricular drainage

76
Q

Sudden severe headache in the occipital area, spreading to the whole head

A

subarachnoid

77
Q

Parient with SAH, aneurysm most common at

A

a. communicans anterior

78
Q

bilateral aneurysm of a. carotis interna can cause

A

binasal haemianopsia

79
Q

likely site of intracerebral haemorrhage due to hyalinosis

A

Thalamus

80
Q
A

Neuro (30 decks)

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