Strokes Flashcards
What is the definition of stroke?
inadequate blood flow to the brain resulting in cell death
What is a TIA?
brief episode of neurological dysfunction that is:
- caused by focal brain or retinal ischemia
- has complete resolution of sx
- typically lass < 1 hr
- w/out evidence of infarction
What is the risk factor for stroke 2 days after TIA?
10%
What are the clinical symptoms of stroke?
- Sudden
- confusion, trouble speaking or understanding
- numbness or weakness of the face, arm, or leg especially on one side of the body
- trouble seeing out of one or both eyes
- trouble walking, dizziness, loss of balance or coordination
- severe headache with no known cause or no prior history of headache
- neglect
What would you be looking for in a CT that indicates stroke?
hypodensity
When looking at a stroke on MRI, what two sets should you look at together?
ADC & DWI
Why do we see brightness with stroke on a DWI MRI?
loss of perfusion → increased edema →influx of fluid/protons that light up
Identify the type of aphasia indicative of leach level of the flow chart
What areas of language do we want to test when assessing stroke?
naming, fluency, comprehensive, repetition, prosed/singing, reading, writing
What are the 2 types of stroke? Which is more common?
- Hemorrhagic: blood leaking out into the brain
-
Ischemic: loss of blood flow (85%)
- thrombolic - clot develops in that specific area (usually d/t plaque build up)
- embolic- clot forms somewhere else & shoots up to the brain (MC cardioembolic stroke)
Identify the characteristics of ischemic strokes relative to the following variable:
Acute / Hyperacute?
Headache?
Consciousness?
Herniation?
Territory?
- Acute / Hyperacute? either
- Headache? none-moderate
- Consciousness? relatively preserved
- Herniation? rare or occurs later
- Territory? clear vascular territory
Identify the characteristics of hemorrhagic strokes relative to the following variable:
Acute / Hyperacute?
Headache?
Consciousness?
Herniation?
Territory?
- Acute / Hyperacute? hyperacute
- Headache? severe
- Consciousness? usually impaired if large
- Herniation? occurs early
- Territory? no obvious territory
Identify the arterial territory of the brain indicated in the provided image
What percent of all strokes are cardiothromboembolic?
20-30%
What are the major risk factors/etiologies for cardiothromboembolic stroke?
atrial fibrillation (x5)
acute MI w/ left ventricular thrombus
mechanical valve (mitral > aortic)
infective endocarditis
DVT → patent foramen ovale
intrapulmonary shunt
Ischemic stroke often occurs in what small-vessel diseases?
This most commonly affects which specific vessels?
HTN / diabetes
vessels in subcortical/basal ganglia/brainstem area
Ischemic stroke often occurs in what large-vessel diseases?
This most commonly affects which specific vessels?
hyperlipidemia, hypovolemia
PCA, MCA, ACA, carotids