Strokes Flashcards
What is the definition of a stroke
Neurological deficit to an acute focal injury of the CNS via a vascular cause
which type of stroke is most common
ischemic
What are common stroke symptoms
diplopia
aphasia
altered sensation
one sided weakness
impaired coordination
altered mental status
headache
If someone has a sudden focal neurologic deficit, what are you most concerned for
stroke
what is a lacunar infarction
infarct following atherothrombotic occlusion of a small artery
What does hypoperfusion of the brain mean
Not enough blood flow and oxygen to the brain… from shock or CPR
What is a paradoxical embolism
a patent PFO allows clots to bypass the lungs and enter the arterial pathway to the brain
If someone has a left MCA stroke, what symptoms would you expect
Right sided deficit
difficulty reading, writing, or calculating
aphasia
If someone has a Right MCA stroke, what symptoms would you expect
Left sided deficit
neglect of left visual field
spatial disorientation
If someone has a basilar stroke, what symptoms would you expect
motor/sensory loss in all 4 limbs
crossed signs
nystagmus
amnesia
What is the penumbra that is seen with a stroke
Salvageable brain area that is in the process of becoming ischemic
What is the most important point to ask with a stroke alert
the patients last known well time
*NOT the same as first seen abnormal
When can you give tpa for a stroke
If hemorrhage has been ruled out
and it is within 4 hours of symptom onset
What is the window that a thrombectomy can be done with a stroke
within 6 hours (24hrs in slow Progressor’s)
What is the general treatment for strokes
antiplatelets or high intensity statin
When is aspirin the treatment of choice for a stroke
when given early
What does the HASBLED score tell you
estimates hemorrhagic risk
What are some post stroke complications
stroke deficits
seizures
aspirations
pneumonia
How long does it take for neuroplasticity to occur
roughly 3 months
What is a TIA
warning sign of impending stroke
what is a silent cerebral hemorrhage
focal collection of chronic blood products within that brain that is not caused by trauma and with no history of neurologic dysfunction
What is an intraparenchymal hemorrhage
Rapidly developing signs of neurologic dysfunction that is not caused by trauma
How would you treat an aneurysm that is <7cm
watch the progression
If someone comes in complaining of having the worst headache of their life, what are you concerned for
subarachnoid hemorrhage from a burst aneurysm
What are some complications with SAH
Recurrent bleeding
hyponatremia
sympathetic storming
hydrocephalus
vasospasm
What are some ways you can treat an aneurysm
coil
clip
medication (ca+ channel blocker)
What is a subdural hemorrhage usually a result of
head trauma
If someone presents with decreased consciousness, slowed/slurred speech, imbalance, numbness, vision problems and hit their head recently, what are you concerned for
Subdural hemorrhage
Where does an epidural hemorrhage occur
between the skull and the dura
What is the most common source of an epidural hemorrhage
MCA from a skull fracture or other head trauma
What is giant cell arteritis
inflammatory vasculitis
What is a serious complication of giant cell arteritis
Irreversible vision loss
What vascular disease process is linked to poly myalgia rheumatica
Giant cell arteritis
How do you treat giant cell arteritis
high dose prednisone
