Stroke - Neuro medi Flashcards
To dx a TIA, what is the criteria?
must last less than 1 hour and not greater than 24 hours
MRI must be negative
What should you initially be looking at on CT if there is a possible CVA?
grey-white disctinction decrease
What is the MCA dot sign?
on CT, a white dot in the M1 positon, thrombus sitting there
How does a stroke look on DWI v ADC?
DWI will have protons light up - edema/fluid area
ADC will be dark area
What are the differences in presentation of ischemic stroke v hemorrhagic stroke?
- ischemic
- moderate or no HA
- consciousness relatively preserved (variable)
- herniation is rare
- clear vascular territory
- hemorrhagic
- hyperacute
- severe HA
- consciousness usually impaired if large
- early signs of herniation
- no obvious territory
What increases stroke risk 5x?
atrial fibrillation
An ischemic stroke in a pt with long standing HTN and DM will likely be what kind of CVA?
small-vessel lacunar stroke in anterior basal ganglia
What am I looking at?
string of pearls sign
watershed MCA-ACA
more proximal occlusion
carotid stenosis or hypotension
What am I looking at? Most likely…
bihemispheric punctate
cardioembolic MC in anterior circulation but can be posterior
What am I looking at ?
What are RF?
large vessel dz
RF: atherosclerotic disease affecting MCA or ACA
What am I looking at? What are RF?
lacunar infarct
RF: HTN, DM, HLD, smoking
What four things could predispose a person to have a carotid dissection?
Ehlers Danlos type IV
Marfans
polycystic kidney disease
osteogenesis imperfecta type I
How long will tpa be effective after an ischemic stroke?
For large vessel occlusion, how long is endovascular thrombectomy effective?
4.5 hours
24 hours
A stroke to the PICA area of the lateral medulla would be considered
Wallenberg Syndrome
Stroke of the vertebral artery perforators and the anterior spinal artery in the medial medulla would be what syndrome?
Dejerines syndrome
Locked in syndrome and stroke of basilar artery causes a disconnect where?
between supratentorium/midbrain from pons and medulla
What are some modifiable RF of CVA?
HTN, HLD, DM, smoking, metabolic syndrome, Afib, carotid stenosis, etoh abuse, obesity, physical inactivity, OSA
Carotid endarterectomy should be done as secondary stroke prevention when…
70-99% stenosis
What is the neurologist’s goal for LDL?
<70
What will stopping smoking for 5 years do for your risk for stroke?
after 5 years cessation, will have same risk as non-smoker
venous sinus thrombosis MC involves..
what is the classic presentation?
superior sagittal sinus
female with HA and hypercoaguable state
