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37 Cards in this Set
- Front
- Back
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What are the MCC of ICH? |
1. HTN 2. Aneurysm 3. AV malformation 4. Illicit drug use |
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What are the ssx of ICH? |
1. Occur over a span of a few minutes to an hour 2. Acute HTN 3. Altered mental status 4. HA 5. Vomiting |
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What are the complications associated with ICH? |
1. Hydrocephalus 2. Herniation |
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When do most ICHs occur? |
1. When patient is awake and calm |
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What are the MC sites of ICH? |
1. Basal ganglia 2. Lobar 3. Thalamus 4. Pons 5. Cerebellum |
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What are the ssx of a basal ganglia ICH? |
1. Contralateral hemiparesis 2. Sensory loss 3. Contralateral conjugate gaze paresis 4. LOC |
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What are the ssx of a lobar region ICH? |
1. Contralateral hemiparesis or sensory loss 2. Aphasia 3. Neglect 4. Confusion 5. Seizures frequent at onset |
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What are the ssx of a thalamic ICH? |
1. Contralateral hemiparesis 2. Sensory loss 3. Gaze paresis 4. Abnormal eye movements |
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What are the ssx of a pontine ICH? |
1. Quadriparesis 2. Facial weakness 3. Decreased consciousness 4. Miosis-- pinpoint pupil |
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What are the ssx of a cerebellar ICH? |
1. Ataxia 2. Gaze paresis 3. Occipital headache |
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What is prognosis of an ICH? |
1. 80% will have sudden onset with HA, rapidly sink into coma 2. 2/3 comatose patients die |
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What are the MCC of SAH? |
1. Trauma 2. Berry aneurysm rupture |
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What are the ssx of SAH? |
1. Worst headache ever 2. N/V 3. Meningismus 4. Altered consciousness |
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What is the urgency of an SAH? |
1. Neurologic emergency--- 50% die |
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What is the cause of a focal deficit in SAH? |
1. Vasospasm |
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What does complete CN III palsy suggest? |
1. Compression from posterior communicating artery aneurysm |
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How do you dx SAH? |
1. LP--- xanthochhromia 2. Cerebral angiography |
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How do you tx SAH? |
1. Surgery within 36 h 2. Prevent re-bleed 3. Maintain cerebral perfusion pressure 4. Tx vasospasm 5. Prevent seizures |
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How do you tx vasospasm? |
1. Nimodipine (CCB) |
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What is the best indicator of outcome from SAH? |
1. Level of consciousness at arteriography |
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What are the leading causes of M/M in SAH? |
1. Vasospasm 2. Re-bleeding |
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What are the ssx of an AVM? |
1. Seizure** 2. Hemorrhage** 3. HA 4. Mass lesions |
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How do you dx AVM? |
1. CT/MRI 2. Arteriography to establish dx |
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How do you tx AVM? |
1. Surgical excision 2. Embolization 3. Ligation 4. Proton radiation (gamma knife) |
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How do you dx ICA dissection? |
1. String sign on arteriography |
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When is arterial occlusion MC in pregnancy? |
1. 2nd and 3rd trimesters 2. 1 week after delivery |
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When is venous occlusion MC in pregnancy? |
1. 6 weeks postpartum |
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What are the characteristics of cortical venous thrombosis? |
1. Slower evolution 2. Multiple lesions 3. Seizures and/or hemorrhage |
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How do you dx superior sagittal venous thrombosis? |
1. Empty delta sign 2. Axial flair on venogram |
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How do you tx superior sagittal venous thrombosis? |
1. Anticoagulation |
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What are the ssx of super sagittal venous thrombosis? |
1. Increased ICP 2. HA 3. Vomiting 4. Papilledema |
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What are the MCC of mycotic aneurysms? |
1. Bacterial endocarditis 2. IV drug abuse |
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What are the MCC of HTN encephalopathy? |
1. Chronic renal disease 2. Acute toxemia 3. Pheo 4. Cushing 5. Cocaine or meth use |
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What are the ssx of HTN encephalopathy? |
1. HTN 2. HA 3. N/V 4. Visual disturbances 5. Confusion |
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What is the lethal combination for migraines with stroke? |
1. Tobacco 2. Hormones 3. Hypercoagulable states 4. Migraine with aura |
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What should you know about meningovascular syphilis? |
1. Strokes due to arteritis caused by neurosyphilis 2. Suspect when a young person has one or several cerebrovascular accidents |
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What is the urgency of temporal arteritis? |
1. Emergency |
