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stroke > Subarachnoid > Flashcards

Subarachnoid Flashcards

0
Q

Risk factors for SAH

A

Htn dia 105, smoking, fungal, oct, liver, trauma, arm, cocaine, amph

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1
Q

Percent of stroke that are SAH

A

10

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2
Q

Biggest risk factor for SAH

A

Fibro muscular dysplasia 25% of aneurysm

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3
Q

Most common place for Subarachnoid aneurysm

A

1/3rd are in anterior
Internal carotid bifurcation with post
Ic with mca

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4
Q

How many with aneurysm have more than 1

A

25 percent

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5
Q

Percent of SAH assoc with poly coatis kidney disease

A

3% overrated

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6
Q

Mean age of SAH

A

50

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7
Q

Context of SAH

A

60 % During activity.

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8
Q

Don’t forget about asking about what w SAH in history

A

Prior episodes

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9
Q

Types of activity associated with SAH

A

Colitis dedication emotional strain I

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10
Q

What does mydriasis mean

A

Cranial nerve 3 deficit, uncal hernia midbrain problem

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11
Q

Cn 3 plus Hemiparesis wo gate abnormality

A

Weber syndrome

Posterior communicating

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12
Q

Lab findings with SAH

A

Hyponatriemia

Qt

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13
Q

Cz of SAH Na deficit

A

Salt wasting, cerebral wasting, siadh

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14
Q

Cz of nuchal rigidity patho

A

Blood degradation products irritate the pia arachnoid which cause stiffness

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15
Q

Peak of vasospasm in days

A

4 to 14 days

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16
Q

How do you detect vasospasm

A

Trancranial Doppler can be used to detect a change in flow velocity

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17
Q

How is a acute communicating hydrocephalus caused from patho

A

Subarachnoid granulation in the venous sinuses obstruct

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18
Q

Percent of nontraumatic aneurysm that are caused by berry

A

80%

Most are associated w trauma

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19
Q

SAH associated with what vital.

A

Diastolic 110

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20
Q

Head ct sensitivity of SAH

A

85 to 90, miss 10 to 15

21
Q

When is ct most sensitive for dr erecting SAH

A

At 24 hr

22
Q

When is lp most sensiive for SAH

A

12 hr

23
Q

What percent of lp miss SAH

A

10 to 15

24
Q

How do you scene for aneurysm of SAH

A

Ct MRI angio

25
Q

Percent of SAH that die in the first 30 days

A

60 percent

26
Q

Hess and hunt category

A
  1. Nuchal and mild ha
  2. Nuchal and sever ha
  3. Nuchal and confusion
  4. Nuchal and Hemiparesis
  5. Nuchal and comatosed
27
Q

What does miningius mean

A

Inflammation without infection

28
Q

What is the miningismus triad

A

Headache
Neck
Photophobia

29
Q

Drug if choose to prevent vasospasm

A

Nimotop

30
Q

Sensitivity and specificity of kernig and brudinski ski

A

5% sens but 95%

31
Q

What is the sensitivity of nuchal rigidity

A

30 sens 80 sens

32
Q

If you see a SAH rupture and are thinking neurosurgey

A

Conventional angiography

33
Q

What consult will you place for an SAH

A

Coiling specialist. Neurointerventionalist

34
Q

Grade and surgery for SAH

A

Low grade is coil

High grade clip

35
Q

When do you clip an aneurysm

A

Before two days or after 2 weeks

36
Q

Complication of SAH

A

Siadh

Hydrocephalus

37
Q

Mainstay med management of SAH

A 
Triple H therapy
Htn
Hyper volume
Hemodilution
Nimodipine
38
Q

How do you evaluate hyper acute Hemiparesis

A

Diffuse weight MRI

39
Q

SAH w 3 rd cranial nerve problem suggests which artery

A

Posterior communicating

40
Q

SAH e cn 6 suggest what type of artery

A

Posterior fossa or increase pressure.

41
Q

What do you call a bleed from am unruptures aneurysm

A

Sentinel bleed

42
Q

What percent of stroke is SAH

A

5%

43
Q

What present of primary stroke is anueysm

A

80 an

44
Q

What percentage of aneurysm re bleeding?

Mortality if untreated ?

A

50%

50% mortality of untreated

45
Q

Where are all aneurysms located?

If not there, what?

A

Circle of Willis
My Cotic
Avm induced aneurysm

46
Q

Work up for SAH

A

Ct to locate bleed, mra

Catheter angio

47
Q

Most common places for aneurysm

A

Communicators (ant and pos) 35%

48
Q

What imaging is good for encephalopathy

A

MRI dt white matter changes

49
Q

HSV perfer what area of the brain

A

Insular and temporal lobe

stroke (13 decks)

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