Imported: Neuro Test 1: Cordingley_Stroke

Front 1

what are some of the important areas that can be damaged by occluding the middle cerebral arteries?

Back 1

Broca/Wiernicke's

Motor/Sensory cortex

Frontal eyelid

Optic radiation... others

Front 2

anterior cerebral artery blockage can lead to problems where

Back 2

leg and foot of motor and sensory

Front 3

Posterior cerebral artery occlusion will give you what major problem?

Back 3

visual deficits

Front 4

non-traumatic Subarachnoid Hemorrhage is normally due to what?

Back 4

aneurysm

Front 5

where do aneurysms typically occur? (berry)

Back 5

close to the circle of willis

most in bifurcation of Anterior communicating (like in marfans)

Front 6

besides trauma, what are the 2 major causes of intraparenchymal hemorrhage?

(o)

Back 6

Hypertension-associated

Arterio-venous malformation (AVM)

note: this is literally bleeding into brain tissue

Front 7

where do Charcot-Bouchard microaneursyms occur? how are these different from Berry aneurysms

*

Back 7

on penetrating arteries (deep in the brain, leading to areas like the basal ganglia)--assoc with intraparenchymal hemorrhage

different from saccular (Berry) aneurysms occurring near the circle of Willis. assoc with subarachnoid hemorrhage

result of HTN

Front 8

large wedge shaped damage vs small pockets of damage...

please list what type of vessels were damaged

(o)

Back 8

Wedges: large vessels

small pockets/lacunae: small (will be in penetrating arteries

Front 9

what is the difference between an embolism and thrombosis

(o)

Back 9

embolism: some garbage from upstream got dislodged, then it gets stuck in the brain

thrombosis: clot...can lead to breaking off and causing an embolism

so: embolism arises from somewhere else, thrombus occurs from the site

Front 10

what is most commonly going to cause an embolism?

Back 10

Atrial fibrillation

(irregularly irregular)

Front 11

what is the concept of ischemic penumbra?

*

Back 11

There is a central core of forever-lost brain cells that no treatment can revive surrounded by a larger zone of sick brain cells that may or may not recover – depending on acute management.

Front 12

in stroke, what effect can blood sugar have on acute stoke management?

Back 12

Too high can be damaging!!

Front 13

what are some of the modifiable atherosclerotic risk factors? 4 (+1 non-modifiable)

(o)

Back 13

Blood pressure
Blood sugar
Lipids (statin drug)
Smoking


note: Family History

Front 14

shortly after stroke it is important to monitor BP. If it is really high what should you do? Should you let a pt walk right away?

Back 14

we lost autoregulation, so be careful not to drop BP too aggressively-->can extend the stoke

so if their BP is high, don't worry about it for the immediate time being

also, don't let them walk, they may have an unsafe drop in BP

Front 15

if you are going to give a drug for acute treatment of thrombotic stroke, which of the following would you use?

t-PA
heparin
aspirin

Back 15

ASPIRIN has small benefit acutely

note: heparin would be good to prevent DVT from bed rest

Front 16

what commonly causes stroke for old and young folks?

(o)

Back 16

old folks: atherosclerosis or emboli from heart

young folks: congenital heart/great vessel defects; hypercoaguable states, migraine with aura + smoking + contraceptives, endocarditis, Hormones**

Front 17

Whats a more common cause of stroke? An infarction or a bleed?

Back 17

Infarction

(MCA, Anterior Communicating)

Front 18

Where do atherosclerotic plaques commonly occur in the brain's vasculature?

Back 18

Bifurcations of arteries

Front 19

What's more common, an arterial or venous stroke?

Back 19

Arterial Stroke