Strokes Flashcards
hemisensory loss with increased pain sensation
thalamic stroke (VPL of thalamus), called Dejerine-Roussy syndrome
internal capsule strokes cause what sxs
motor sxs
cerebral vs thalamus stroke
cerebral (and basal ganglia): eyes deviate away from hemiparesis
thalamus: eyes deviate toward hemiparesis
HTN and stroke sxs
stroke of deep structures (intraparenchymal brain hemorrhage of basal ganglia (putamen!), thalamus, pons)
internal capsule almost always involved –> CL hemiparesis
sxs of pontine hemorrhage
complete paraplegia
deep coma
pinpoint pupils
decerebrate rigidity
complete paraplegia
deep coma
pinpoint pupils
decerebrate rigidity
pontine hemorrhage
sxs of central cord syndrome
burning pain and paralysis in upper extremities
sxs of Brown Sequard (acute hemisection)
IL motor and proprioception loss
CL pain loss
decorticate posturing
hemorrhage in midbrain
decerebrate posturing
hemorrhage in pons
most common site of hypertensive hemorrhage
putamen (which is close to internal capsule, so you’ll see CL hemiparesis)
loss of movement & sensation in UE
central cord syndrome
central cord syndrome occurs in what kind of injuries
hyperextension
stroke presenting within 3.5 hours of sx onset and no contraindications, tx with
IV alteplase
stroke w/ no prior antiplatelet therapy, tx with
ASA
stroke on ASA, tx with
ASA + dipyridamole
or
clopidogrel
stroke on ASA and patient w/ intracranial large artery atherosclerosis, tx with
ASA and clopidogrel
stroke w/ evidence of a fib, tx with
long term anticoagulation
- warfarin
- dabigatran
- rivaroxaban
tx of acute spinal cord injuries
methylprednisolone
tx of spinal tumor
dexamethasone
Brown Sequard syndrome sxs
IL motor loss of limb (CST)
IL loss vibration and proprioception (DCML)
CL loss of temp and pain (lat CST)
pt already dx with stroke, what’s the first step in management
swallow study
