Term
| What somatic motor function is generally affected by a middle cerebral versus an anterior cerebral artery stroke? |
|
Definition
Anterior: Typically the legs
Middle: Arms and Face |
|
|
Term
| Major types of stroke and which is the most common? |
|
Definition
Hemorrhagic
Ischemic: More frequent with Thrombus as the major cause |
|
|
Term
| What exam can you do none invasively to visualize an embolic stroke? |
|
Definition
|
|
Term
| What is the most sensitive imaging for ischemic stroke? |
|
Definition
|
|
Term
| What are some functional deficits suggestive of MCA stroke |
|
Definition
Sudden Onset of:
Contralateral Weakness
Contralateral Sensory
Contralateral Visual field
Ipsilateral Monocular blindness(ICA)
Lethargy w/o Coma
Language Disturbances(if left side) |
|
|
Term
| What are some functional deficits suggestive of Vertebrobasilar Strokes |
|
Definition
Slower Onset of:
Contralateral Weakness(not face)
Contralateral Sensory(not face)
Contralateral Visual field
Ipsilateral Cranial nerve deficits
Lethargy and Coma
Incoordination |
|
|
Term
| Classification of TIA and Stroke |
|
Definition
|
|
Term
| What are the two distinct approaches to acute stroke therapy |
|
Definition
Reperfusion
Neuroprotection |
|
|
Term
|
Definition
| A transiently injured zone that is still viable |
|
|
Term
| What are the major reperfusion strategies and which have evidence for effectiveness |
|
Definition
Have evidence:
Thrombolysis
Mechanical clot removal
Have little evidence:
Anticoagulation
Lowering blood viscosity
Bypass |
|
|
Term
| What are the advantages and disadvantages to Intra-Arterial tPA administration |
|
Definition
Advantages: Lower dose required, Longer window of opportunity
Disadvantages: Requires Arteriograms |
|
|
Term
| What are the contraindications to tPA use |
|
Definition
Minor or Improving Symptoms
Hypoglycemia(<40)
HPTN(>185)
Seizures
Anticoagulation tx
Bleeding
Surgeries |
|
|
Term
| What are the predictors of hemorrhage with tPA use? |
|
Definition
Ischemic Change on CT
High NIHSS score >20
Increasing Age |
|
|
Term
| What are the potential approaches to extending the viabilty of the prenumbra |
|
Definition
Hypothemia before tPA used in Anoxic Stroke
Neuroprotective Strategies |
|
|
Term
| Why do patients arrive too late to initiate tPA |
|
Definition
Older population
Living alone
Affects motor/language skills
Doesn't hurt
Denial
View that it can't be treated |
|
|
Term
| What are the modifiable risk factors for stroke |
|
Definition
Diabetes
HPTN
Hyperlipidemia
Physical Activity
Obesity
Smoking
Alcohol
|
|
|
Term
| What are the antithrombotic agents used in noncardioembolic CVA? |
|
Definition
Aspirin
Clopidogrel
Dypyridamole/ASA
Warfarin |
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