Stroke II

Question 1

What stroke types come on during the day, and what come on while pt is asleep?

Answer 1

day: embolic or hemorrhagic

night” thrombotic

Question 2

What questions should I ask about strokes in young ppl?

Answer 2

OCP, hematologic disorders like sickle cell, polycythemia, collagen disorders, Marfan

Question 3

What should I consider in stroke pt with limited neck range of motion?

Answer 3

vertebral arteries: pass through the tranasverse spinal canals, which are narrowed in osteoporisis

Question 4

What are examples of vasuclar malformations that cause hemorrhagic stroke?

Answer 4

AVM: direct artery-to-vein connection w/o intervening capillary bed. usually in the supratentorial areai. 1-3% annual risk of intracranial hemorrhage
cavernoma: lobulated collection of endothelial-lined space: popcorn appearance on MRI with GRE. 1% annual risk of ICH

Question 5

What are some causes of cerebral venous thrombosis?

Answer 5

hypercoaguable state (pregnacy, OCP and smoking, etc)
local infection, esp. in kids (mastoiditis)
tumor
venous stasis (dehydration, for example)
trauma
autoimmune
idiopathic

Question 6

What are some clinical features of cerebral venous thrombosis?

Answer 6

raised ICP, focal deficits, seizures

Question 7

What are signs of anterior choroidal artery stroke?

Answer 7

hemiparesis, field cut, maybe sensory deficits if thalamus is disrupted.

Question 8

What is the recurrent artery of Huebner?

Answer 8

branch of ACA that supplies the ehad of the caudate and can present with neuropshyche symptoms

Question 9

Some symptoms of MCA stroke

Answer 9

visual field cut, language impairment (dominant hemisphere), neglect (non-dominant hemisphere), apraxia, agnosia, forced gaze/gaze preference

Question 10

Findins with the berebro-basilar stroke

Answer 10

eye movement problems
dysarthria/dysphagia
pupillary changes
mixed sensory-motor deficits
ataxia
vertigo