Strokes Flashcards
Fourth leading cause of death in the US
stroke
Most common area for strokes
anterior circulation from internal carotid (2/3)
Most common type of stroke
ischemic (80%)
What does FAST stand for?
facial drooping, arm weakness, speech difficulty, time to call 911
Most commonly affected vessel of anterior strokes
middle cerebral artery (96%)
Sx include: Amaurosis fugax, Face-hand-arm-leg hemiparesis, Aphasia/dysarthria
Anterior circulation stroke
Arteries that make up posterior circulation
Vertebral artery, Basilar artery, Posterior cerebral arteries
Sx include: apraxia, aphasia, contralateral hemiplegia in face-arm-leg, person doesn’t recognize their body
MCA occlusion
What circulation supplies the brainstem, thalamus, hippocampus, cerebellum, visual cortex, temporal lobes, occipital lobe?
posterior circulation
Where are CN III and IV located?
midbrain
Where are CN V, VI, VII, VIII located?
pons
Where are CN IX, X, XI, XII located?
medulla
Mortality associated with basilar artery occlusion
90%
Sx include: vertigo, diplopia, sensorimotor deficits, dysarthria, ataxia
posterior circulation stroke
What kind of stroke can have Ipsilateral face and contralateral limbs involvement?
Posterior circulation stroke
5 D’s of posterior stroke
Dizziness, Diplopia, Dysarthria, dysphagia, dystaxia
Sx include: HA, ataxia, nausea/vomiting, paralysis in tongue and swallowing all ipsilateral, Ipsilateral face and contralateral body
Vertebro-Basilar posterior circulation occlusion
What type of stroke is more likely to have a severe HA?
hemorrhagic
Secondary to the lenticulostriate arteries off the MCA
Lacunar strokes
Type of stroke where patients deteriorate more rapidly and have H.A., N/V, and decreased consciousness as prominent signs
hemorrhagic stroke
Type of hemorrhagic stroke that bleeds directly into brain tissue from small arterioles or arteries
Intracerebral
Etiologies include: HTN, trauma, bleeding diathesis, vascular malformations (ruptured saccular aneurysms), AVM’s
intracerebral stroke
Arteries and veins connected in such a way that there is no capillary bed at all resulting in higher than normal pressures in the veins
AVMs
Type of hemorrhagic stroke due to rupture of an artery with bleeding onto the surface of the brain
subarchnoid hemorrhage
Number one cause of subarchnoid hemorrhage
Aneurysm
Sx include: worst HA of life, maximum intensity at onset, phono or photophobia, papillary edema
subarachnoid hemorrhage
Most common causes of intracerebral hemorrhage
Hypertension, Amyloid angiopathy
Drugs associated with hemorrhagic stroke
amphetamine and cocaine
Characterized by impaired ability to speak and understand others and experience difficulty reading and writing
aphasia
Type of aphasia where speech output is reduced to less than four words and difficulty reading/writing. Comprehension is intact
Broca’s aphasia (expressive aphasia)
Type of aphasia in persons who are left with a persistent inability to supply words for the things that they want to talk about.
anomic aphasia
Type of aphasia characterized by few recognizable words, Understands little or no spoken speech, Can neither read or write
global aphasia
What vessel supplies Broca’s area?
superior division L MCA
What vessel supplies Wernicke’s area?
inferior division of the L MCA
Aphasia where speech is fluent but meaningless and individual is unaware of language errors. Comprehension is poor
Wernicke’s aphasia (receptive aphasia)
What imaging should be ordered for acute work-up of stroke?
noncontrast brain CT
Tasks covered by right hemisphere
analytical and perceptual
Tasks covered by left hemisphere
speech and language
Timeframe for treating strokes
window of opportunity is to treat stroke patients within 3-4.5 hrs. Patients need to get to hospital within 60 minutes
After what period of time post stroke is complete recovery of aphasia unlikely
If symptoms last longer than two or three months
NIH stroke scale classifications
0-no stroke. 1-4: minor stroke. 5-15: moderate stroke. 16-20: moderate to severe stroke. 21-42: severe
Absent pulse in radial or carotid points to a diagnosis of….
Atherosclerosis with Thrombosis
