Stroke Lec 12 Flashcards
Non-modifiable RFs for Stroke
Age
Sex
Race/ethnicity
FHx
Modifiable RFs for stroke
Hypertension Diabetes Smoking Hyperlipidemia Carotid stenosis A-fib
L-MCA
Right hemiparesis Face=hand>arm>leg Aphasia- expression/reception Anterior- left head and eye deviation Posterior- visual field deficit, aphasia
R-MCA
Left hemiparesis Face=Hand>arm>leg Neglect Anterior- right head and eye deviation Posterior- visual field deficit, Neglect
PCA
Visual field deficit or cortical blindness if bilateral
May have hemihypaesthesia
Basilar Artery
Altered consciousness or coma
Often bilateral signs
Cranial nerve signs and crossed signs
-right facial weakness and left arm and leg weakness
Lacunar syndromes
Motor hemiplegia- internal capsule- face=arm=leg
Sensory hypaesthesia- thalamus- face=arm=leg
Dysarthria clumsy hand syndrome- pons
ataxic hemiparesis
Aphasia usually corresponds to
Left hemispheric stroke
right sided weakness
Neglect usually indicates
Right hemispheric stroke
Pts usually look— lesion
towards
Crossed signs indicate
brainstem involvement
Hyperdense MCA signs
BAD
major ischemic event coming
TPA inclusion
Acute ischemic stroke
Age<24
Absence of exclusionary criteria
Informed consent
TPA exclusion
CT signs of hemorrhage or very large infarct undermined time of onset Uncontrolled HTN or Blood sugar Recent trauma, major surgery or bleeding Abnormal coagulation profile PT/INR Rapidly resolving deficit Hemodynamic compromise from MI
