Strokes and SAH Flashcards
ischemic stroke
- MCC
- less common causes
MCC - atherosclerosis (aortic arch, cervical a., large intracranial a., small cerebral vessels)
cardioembolism (afib, low EF –>ventricular thrombus, paradoxical)
Less common - cervical a. dissection, endocarditis, vasculitis, reversible cerebral vasoconstriction syndrome (RCVS/Call-Fleming), hypercoaguable state (malig, APL, HUS/TTP, nephrotic), global hypoperfusion, vascular compression (herniation syndromes)
ischemic stroke
- basic workup
immediate: NIHSS, focused HPI (tPA C/I, anticoag/antiPLT)
Labs: INR/PLT, BP
Noncontrast CT +/- CTA/MRI
Later: TTE, ECG+/-Holter
tPA Exclusion Criteria:
- head trauma/stroke w.in ________________________
- noncompressible arterial puncture w/in ______________________
- any history of ____________________
- non-responsive BP> __________/___________
- PLT count ____________
Relative C/I
- major surgery/trauma w/in ____________________
- GI or Urinary hemmorhage w/in _________________
- acute MI w/in _______________
- head trauma/stroke w.in ________3 months________________
- noncompressible arterial puncture w/in ________7 days______________
- any history of _________intracranial hemmorhage___________
- non-responsive BP> ____185______/___110________
- PLT count ____1.7________
Relative C/I
- major surgery/trauma w/in _______14 days_____________
- GI or Urinary hemmorhage w/in ______21 days___________
- acute MI w/in _____3 months__________
Common complications of acute ischemic stroke
hemmorhagic transformationvof infarct beds (friable infarcted tissue)
malignant cerebral edema (swelling of infarcted tissue)
Hemmorhagic Stroke (15%) - ICH or SAH - MCC
MCC: HTN, trauma, bleeding, amyloid, illicit drug use
