Stroke/TIA

Question 1

Young female patient presents with headache and focal neurological deficits 1 week after giving birth. What is likely diagnosis?

Answer 1

Cerebral venous thrombosis

Question 2

What is the study of choice for cerebral venous thrombosis?

Answer 2

MRV

Secondary is CT venogram

Question 3

What are risk factors and classic patients who get cerebral venous thrombosis?

Answer 3

Risk factors: female, pregnancy or puerperium, malignancy, prothrombotic states, oral contraceptives, infection, head injury

Tend to be younger patients than those who get strokes

Question 4

What clinical presentations may signify a cerebral venous thrombosis?

Answer 4

Headache in someone with no hx of headaches
Encephalopathy
Seizure
Focal neuro findings

Question 5

Patient has weakness in the face and upper extremity more than the lower extremity. This is consistent with occlusion of which cerebral artery?

Answer 5

Middle Cerebral Artery affects the face and the upper extremity more than the lower extremity

Question 6

Occlusion of the anterior cerebral artery tends to produce motor deficits where? What are the other symptoms of an anterior stroke?

Answer 6

ACA occlusion is more likely to cause lower extremity findings as compared to MCA and the UE/face

Other findings: dysfunction of the frontal lobe, apraxia

Question 7

What defects are typical in a PCA stroke?

Answer 7

Visual deficits
3rd nerve palsy (down and out) with pupil involvement
LOC, N/V, CN dysfunction, ataxia, visual agnosia are more common

Question 8

What are CT findings in ischemic stroke?

Answer 8

Loss of gray/white interface, acute hypodensity