Unit 2: TBI and Stroke Flashcards

1
Q

L1: Which pathologic finding? Concussion with catastrophic cerebral congestion and increased intracranial pressure due to pathologic dysregulation of intracranial vessels

A

Second Impact Syndrome

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2
Q

L1: Which pathologic finding? Downward pressure centrally that causes bilateral uncal herniation

A

Central herniation

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3
Q

L1: Which pathologic finding? Intracraial bleeding resulting from tearing of bridging veins that connect the cortical surface to the sagittal sinus

A

Subdural Hematoma

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4
Q

L1: Which pathologic finding? Protrusion of the cerebellar tonsils down into the foramen magnum, which can produce Cushing’s reflex by medullary compression

A

Tonsillar herniation

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5
Q

L1: Which pathologic finding? Uncus crosses the tentorial edge and pushes into the posterior fossa, compressing on midbrain, cerebral peduncle, and ispilateral, oculomotor nerve

A

Uncal herniation

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6
Q

L1:Which pathologic finding? Intracranial bleeding frequently resulting from fractures near the middle meningeal artery

A

Epidural Hematoma

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7
Q

L2: ______ infarcts appear on Diffusion Weighted Imaging (DWI) MRI.

A

New

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8
Q

L2: ______ infarcts appear on FLAIR T2-weighted MRI.

A

Old

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9
Q

L2: Imaging protocol for suspected stroke: _______ > _______ > ________

A

Noncontrast CT; Perfusion CT; CT angiogram

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10
Q

L2: On CT scan, hemorrhagic strokes appear _____ (whiter/darker), or more radio______, than surrounding brain tissue.

A

whiter; -paque

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11
Q

L2: On CT scan, ischemic strokes appear _____ (whiter/darker), or more radio_____, than surrounding brain tissue.

A

darker; -lucent

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12
Q

L2: On MRI, infarcts appear ______.

A

white

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13
Q

L2: On perfusion CT, at-risk tissue shows _____ time to perfusion, ______ time to peak, and ______ blood flow

A

increased; increased; normal

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14
Q

L2: On perfusion CT, completed infarcts show ______ time to perfusion, _______ time to peak, and ______ blood flow

A

increased; increased; decreased

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15
Q

L2: Surgical Treamtment for ischemic strokes

A

Endarterectomy

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16
Q

L2: Treatment for hemorrhagic stroke prevention

A

Aneurysm clipping or coiling

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17
Q

L2: Treatment for ischemic stroke resuscitation

A

t-PA

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18
Q

L2: What is a sign visible on imaging that demonstrates axonal injury has occurred?

A

Hemorrhage

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19
Q

L2: Which pathologic finding? A brief episode of neurologic dysfunction caused by focal brain or retinal ischemia with clinical symptoms typically lasting less than one hour, without evidence of acute infarction

A

Transient Ischemic Attack (TIA)

20
Q

L2: Which pathologic finding? Arterial media hyptrophy that can result or occlusion or stenosis, commonly in the carotid artery

A

Fibromuscular Dysplasia

21
Q

L2: Which pathologic finding? Associated with arterial dissection and intracranial saccular aneurysms

A

Fibromuscular Dysplasia and Moya Moya Disease

22
Q

L2: Which pathologic finding? Can cause a duret hemorrhage in which the ascending reticular activating system is disrupted

A

Uncal herniation

23
Q

L2: Which pathologic finding? Cingulate gyrus is pushed away by a mass effect and herniates beneath the falx cerebri

A

Subfalcine herniation

24
Q

L2: Which pathologic finding? Edema resulting from brain swelling due to breakdown of the blood-brain barrier

A

Vasogenic edema

25
Q

L2: Which pathologic finding? fixed focal neurological deficit attributable to arterial or venous territory, typically lasting longer than 24 hours with evidence of acute infarction

A

Ischemic Stroke

26
Q

L2: Which pathologic finding? Focal occlusion of the middle cerebral artery due to intimal hyperplasia

A

Moya Moya Disease

27
Q

L2: Which pathologic finding? Intracranial bleeding resulting from translational acceleration changes

A

Subdural Hematoma

28
Q

L2: Which pathologic finding? Intracranial bleeding that occurs on the rough bony surface of the anterior fossa or along the edge of the sphenoid greater wing

A

Subdural Hematoma

29
Q

L2: Which pathologic finding? No gross findings on CT, retraction balls on microscopic analysis

A

Diffuse Axonal Injury (DAI)

30
Q

L2: Which pathologic finding? Presents following injury with a lucid interval followed by progressive obtundation and coma

A

Epidural Hematoma

31
Q

L2: Which pathologic finding? Presents with severe short-onset headache with mortality in the majority of patients

A

Subarachnoid hemorrhage

32
Q

L2: Which pathologic finding? Results from high velocity rotational acceleration injury

A

Diffuse Axonal Injury (DAI)

33
Q

L2: Which pathologic finding? Stroke most commonly occurring in the basal ganglia, thalamus, pons, or cerebellum

A

Intracranial hemorrhage

34
Q

L2: Which pathologic finding? Swelling of astrocytes in response to extracellular hyperkalemia and high potassium uptake

A

Cytotoxic edema

35
Q

L2: Which pathologic finding? Type of stroke most commonly caused by trauma and ruptured aneurysm in atraumatic patients

A

Subarachnoid hemorrhage

36
Q

L2: Which vascular involvement? Stroke resulting in lower extremity numbness and weakness

A

Anterior cerebral artery

37
Q

L2: Which vascular involvement? Stroke resulting in upper extremity asymmetric weakness

A

Middle cerebral artery

38
Q

L2: Which vascular involvement? Stroke with acute onset movement disorders of asymmetric distribution

A

Small vessels

39
Q

L2: Which vascular involvement? Stroke with coma

A

Basilar artery

40
Q

L2: Which vascular involvement? Stroke with vision disturbances

A

Posterior cerebral artery

41
Q

L3: Domains of Scoring in the Glasgow Coma Scale

A

Eye Opening, Motor Response, Verbal Response

42
Q

L3: Mechanisms of reducing intracranial pressure (3)

A

osmotic diuretic (mannitol), drain CSF, induce coma (barbiturates)

43
Q

L3: New infarcts appear on ______ MRI.

A

Diffusion-Weighted Imaging (DWI)

44
Q

L3: Old infarcts appear on ________ MRI.

A

FLAIR T2-weighted

45
Q

L3: Treatment for ischemic stroke prevention (3)

A

Aspirin, thienopyridines, anticoagulants