Stroke Scales Flashcards
Which arteries may cause cortical signs during stroke?
ACA, MCA, PCA
What is the difference between transcortical motor aphasia and broca’s aphasia?
both are NOT fluent and can comprehend, but ..
Transcortical motor aphasia - can repeat
Broca’s aphasia - CAN’T repeat
Hemiparesis due to infarction of recurrent artery of heubner is most prominent where?
Face and upper extremities
This is the most common location of stroke in the cerebral cortex
MCA
T/F: MCA supplies the caudate nucleus and the corpus callosum
F- ACA supplies the caudate nucleus (via RAH) and corpus callosum
T/F: The opercular syndrome (Foix Chavany-Marie Syndrome) causes pseudobulbar palsy with bilateral insular lesions, affecting CN V, VII, IX
T
Which artery supplies the parasylvian fissure?
Which artery supplies the subcortical areas (thalamus, hypothalamus, posterior aspect of internal capsule, midbrain, CN3 and 4 nuclei)
MCA
PCA
Which artery is affected when it presents with homonymous hemianopsia with macular sparing?
What supplies the macula?
PCA
MCA
Presentation of subcortical strokes (3)
motor deficits
loss of sensation
intact speech and awareness
This is the main sensory relay station of the brain
Thalamus
This type of subcortical stroke has unilateral weakness and no sensory impairment
Which brain component is affected?
Pure motor
Contralateral posterior limb of the internal capsule
This type of subcortical stroke has unilateral numbness and no motor impairment
Which brain component is affected?
Pure sensory
Thalamus
T/F: Brainstem strokes have a crossed findings pattern
T
CNs situated at midbrain:
in the pons:
in the medulla:
Midbrain - 3,4
Pons: 5-8
Medulla: 9-12
4Ms Medial Structures
Motor pathway
Medial lemniscus
Medial longitudinal fasciculus
Motor component of cranial nerves
4Ss Lateral structures
Spinocerebellary pathway
Spinothalamic Tract
Sympathetic Pathway
Sensations from the face
This is the main blood supply to the brainstem
Vertebrobasilar system
What is the modified rankin scale score for moderately severe disabililty; unable to walk without assistance and unable to attend to own bodily needs without assistance
4
What is the modified rankin scale score for severe disability, bedridden, incontinent, and requires constant nursing care and attention
5
What are the ICH SCORE components?
GCS score
Age >/80
ICH volume >/30
Intraventricular hemorrhage
Infrantentorial origin of hemorrhage
What will the patient score be in Hunt and Hess scale if she is alert and oriented, with full nuchal rigidity but no neurological deficit?
2
What will the patient score be in Hunt and Hess scale if she is alert and oriented, with minimal nuchal rigidity and mild headache?
1
What will the patient score be in Hunt and Hess scale if she is confused and with mild neurological focal deficits?
3
What will the patient score be in Hunt and Hess scale if she comatose?
5
what is the Fisher grading when no SAH is detected?
1
What is the difference between fisher grading and Hunt and Hess scale for SAH?
Hunt and Hess scale- measures risk of surgical mortality on patients admitted with aneurysmal SAH
Fisher Scale- measures risk of cerebral arterial vasospasm in patients with aneurysmal SAH
What is the fisher grading if there is no SAH but with ICH or IVH
4
What is the fisher grading if there is localized clot within the subarachnoid space that is 3 mm thick
3
minimum: 1mm thick
T/F: Grade 2 Fisher refers to localized layer of subarachnoid blood that is <1mm thick
F- must be diffused
Components of ABCD2 Scoring for TIA
Age >/60
BP >/140/90
Clinical Features of TIA (unilateral weakness, speech disturbance w/o weakness)
Duration of symptoms
Hx of Diabetes
