Term
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Definition
1. ischemic (85%) 2. hemmorrhagic (15%) |
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Term
2 common sites for thrombosis of cerebral arteries: |
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Definition
1. cerebral artery branch 2. internal carotid artery |
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Term
6 well documented risk factors for ischemic stroke: |
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Definition
1. HTN 2. Smoking 3. Heart Dz; CAD, LVH, chronic A-fib 4. Hyperlipidemia 5. DM 6. Sickle cell dz |
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Term
4 hematologic causes of ischemic stroke: |
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Definition
1. deficiency of natural anti-coagulants such as Protein C&S, ATIII 2. Clotting factor xs 3. fibrinolytic factor deficiency; plasminogen, plasminogen activator, FXII deficiencies 4. PCV, Sickle cell, increased plt activity |
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Term
carotid territory: %ischmic strokes & area affected |
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Definition
makes up 90% of ischemic strokes and affects the anterior portion |
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Term
vertebrobasilar territory: is a junction of? affects which portion? |
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Definition
junction of the vertebral artery and hte basilar artery, makes up 7% of ischemic strokes and casuses a posterior stroke. |
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Term
carotid territory presentation: |
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Definition
1. amaurosis fugax (loss of vision in one eye) 2. alternations in consciousness 3. Aphasia 4. facial weakness/asymmetry 5. incoordination of limbs on one side 6. sensory loss on one side |
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Term
vertebrobasilar territory presentation: |
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Definition
1. occipital HA 2. Ataxia/poor balance 3. monoccular or binoccular vision loss 4. Diplopia/photophobia 5. Vertigo, N/V, phonophobia 6. Unilateral hearing loss |
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Term
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Definition
Transient Ischemic Attack causing reduction or cessation of cerebral blood flow lasting 20min-1hr without persentation of neurologic findings |
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Term
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Definition
1. anti-platelet agents: aspirin, plavix 2. Anti-coagulants: after RO intracranial hemorrhage, admin coumadin get INR 2-3 |
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Term
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Definition
1. carotid endarterectomy; used for stenosis of >50% |
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Term
5 initial neurological assessments of Ischemic stroke: |
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Definition
1. LOC 2. Glasgow Coma Scale 3. Brief neuro exam 4. Ocular findings 5. meningeal signs |
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Term
glasgow coma scale includes: |
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Definition
1. eye opening (1-4) 2. verbal response (1-5) 3. motor response (1-6) |
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Term
TQ: glasgow score that won't require intubation: |
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Definition
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Term
Middle Cerebral Atery Occlusion Presentation: |
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Definition
1. contralateral: hemiparesis, hypesthesia 2. Ipsilateral hemianopsia 3. gaze toward side of lesion 4. weakness of upper extremities/face is worse than lower extremeties |
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Term
Anterior cerebral artery occlusion presentation: |
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Definition
1. disinhibition c speech preservation 2. produces primitive reflexes (grasping sucking) 3. contralateral weakness; greater in lower extremities 4. gate apraxia 5. urinary incontinence |
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Term
posterior cerebral artery occlusion presentation: |
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Definition
1. contralateral homonymous hemianopsia 2. altered mental status 3. impaired memory |
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Term
vertebrobasilar artery occlusion presentation: |
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Definition
1. vertigo/ataxia 2. nystagmus/diplopia/visual field deficits 3. dysphagia 4. facial hypesthesia 5. syncope 6. ipsilateral cranial deficits and contralteral motor deficits |
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Term
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Definition
the occlusion of small perforating arteries of the deep subcortical areas of the brain |
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Term
Lacunar strokes are most common in: |
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Definition
people with small-vessel dz, such as DM and HTN |
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Term
Lacunar stroke presentation: |
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Definition
1. do not lead to impairment of cognition, speech or LOC 2. hemiparetic signs |
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Term
imaginge useful in detecting hemorrhage: |
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Definition
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Term
imaging useful in detecting early edema: |
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Definition
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Term
indications for lumbar puncture in the presence of stroke sx: |
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Definition
used if CT is negative & subarachnoid hemorrhage is suspected |
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Term
on CT: hyperdense image in a major intracranial artery: |
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Definition
vascular embolic material/calcification |
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Term
3 inclusion criteria for admin of thrombolytic (tissue plasminogen activator) |
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Definition
1. >18yo 2. dx ischemic storke causing neuro deficits 3. time of sx onset is well estab to be <3hrs |
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Term
exclusion criteria for thrombolytics: |
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Definition
1. increased bleeding risk: evidence of bleed, >INR, 400
3. stroke/MI wn 3mo
4. seizure at onset of stroke
5. surgery wn 14days |
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