tia

Question 1

transient ischemic attack

Answer 1

w/o acute infarction
acute, focal cerebral insufficiency lasts <24, usually <60 min, no residual effects, just 1 vessel so only 1 part of brain
M>F
increased r/o stroke: highest w/n 1 mo

Question 2

presentation

Answer 2

varies, but recurrent are usually similar
abrupt onset and recovery
s associated with location of defect, follow vascular line (where is blood supply going?)

Question 3

bells palsy v tia

Answer 3

tia recovers more quickly
problem or paralysis with facial nerve, can recover with time and tm

Question 4

carotid area - cm

Answer 4

weak, heaviness in contralateral arm, leg, face
contralateral = cross midline, damage on opposite side
numb, dysphagia (swallow - NPO), ipsilateral monocular vision loss
ipsilateral = same side damage

Question 5

vertebrobasilar area

Answer 5

dim or blurry vision, vertigo, dysphasia (speech), ataxia, motor or sensory change
ipsilateral face, contralateral body

Question 6

dx

Answer 6

H+P important: identify pattern, hx, any vascular problems
CT!, MRI, MRA (w/ dye): rule out hemorrhage, lacunar infarcts, or aneurysms
lacunar infarcts: tiny w/o s/s but can see on CT
carotid doppler studies -> carotid stenosis (build up causing decrease BF to brain)
echocardiogram to assess for cardiac source -> clot, etc

Question 7

tm

Answer 7

depend upon etiology, decreased r/o stroke
anticoag: ASA (no benefit or high dose over low dose), clopidogrel (antiplt), heparin and warfarin if cardiac related
carotid endareterectomy with >70% stenosis or angioplasty (balloon)
education to decrease modifiable rf, lifestyle change