Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

37 Cards in this Set

  • Front
  • Back
From what vessles do perforators come off?
MCA and PCA portions of the circle of Willis
What is the breakdown of the 2 types of strokes?
Ischemic (85%) and Hemorrhagic (15%)
What are the causes of large vessel strokes?
embolic or thrombotic; occlusion of ACA, MCA or PCA, vetebral, basilar or major branches of these
What are the causes of small vessel strokes?
Due to occlusion of "deep perforators" that come off the vessels; ususally affected by lipohyalinosis; less commony emboli
What are some modifiable stroke risk factors?
cigarette smoking, diabetes, hypertension, TIA, previous stroke, asymptomatic carotid bruit/ stenosis, cardiac disease (MI, CAD, a fib), dyslipidemia, alcohol consumption, obesity, polycythemia, high homocysteine, low B12, low folate, oral contraceptives
What are some unmodifiable stroke risk factors?
increasing age, male sex, african american ethnicity, positive family hx, genetic factors
What are some embolic sources
large arteries within the cranium (artery to artery embolization), orgins of the internal carotid arteries and vertebral arteries, aortic arch (mobile plaques), heart (valvular disease, a fib, recent MI, sick-sinus syndrome)
What are the clinical presentations of a MCA stroke?
face, arm > leg weakness, proximal MCA occlusion -> contralateral hemiplegia, conjugate eye deviation TOWARD side of infarct, hemianesthesia, hemianopia, global aphasia (if dom.), hemineglect (if non-dom.), anterior divison MCA -> Broca's aphasia, Posterior division MCA -> Wernicke's-type aphasia
What is the clinical presentation of an ACA stroke?
contralateral weakness in leg > arm, face; gait disturbance; urinary incontinence
What is the clinical presentation of a PCA stroke?
depends on portion affected; p1 segment: thalamic, occipital and temporal lobe infarctions; distal segments: more limited infractiosn in areas above: Quadrantanopsia
What is the presentation of a basilar stroke?
various syndrome sthat may involve global depression of consciousness, vertigo, ataxia, nystagmus, nausea, vomiting, gaze palsies, crossed sensory symptoms, Horner's syndrome, and loss of facial sensation
What is some of the presentations of a lacunar stroke?
PURE MOTOR hemiparesis (corona radiata, internal capsule, midbrain or pons), Ataxic hemiparesis, Clumsy-hand dysarthia (pons, less likely thalamus), Pure sensory (thalamus), and mixed sensory/motor (internal capsule +/- thalamus or pons)
What vessel supplies the head of the caudate?
The Recurrent Artery of Huebner that comes off the proximal ACA
From what vessel does the recurrent Artery of Huebner come off?
The proximal ACA.
What is used to treat an embolic source of a stroke?
IV Heparin
When is a CEA indicated?
When there > 70% stenosis; should be considered in those with 50 to 70% stenosis.
What is used as secondary stroke prophylaxis?
Anti-platelet therapy.
What are the most likely ocations for hemorrhagic strokes?
Putamen (35%), Lobar (25%), Cerebellar (5-10%), Thalamus (10-15%), Pons (5%), Caudate (5%)
What is the most common cause of ICH?
What are some secondary causes of ICH?
amyloid angiopathy, Moyamoya disease, AVMs, aneurysyms, other vasculitides, bleeding disorders, anticoagulation, trauma, tumors, cavernous hemiangiomas, illicit drug use.
What are the treatments for hemorrhagic stroke?
surgery in cases of large cerebellar hemorrhages (e.g. > 3cm); craniectomy vs sterotactic aspiration in selected extreme cases; intraventricular catheter to reduce increased intracranial pressure; gentle lowering of blood pressure.
What comprises the anterior circulation?
-paired ICAs
anterior choroidal a.
anterior cerebral a.
middle cerebral a.
What comprises the posterior circulation?
-vertebral aa.
arise from subclavian aa.
-join to form the basilar a.
-brancehes of include the PICA, AICA, SCA, PCA and perforating vessels
What is supplied by the anterior circulation?
-subcortial white matter
-basal ganglia
-internal capsule
What are the presentations of anterior circulation deficits?
-visual field defects
What is supplied by the posterior circulation?
*occipital and temporal lobes
What are the presentations of posterior circulation deficits?
*cranial nerve palsies
*CROSSED motor and sensory deficits
What are cortical signs?
*aphasia (dominant)
*neglect (non-dominant)
*visual field defects
Cortical strokes occur when what arteries are affected?
large arteries - ACA, MCA, PCA
What artery supplies the posterior limb of the internal capsule?
Anterior choroidal a.
What are the features of an embolic stroke?
*defecit maximal at onset
What are the sources of an embolic stroke?
*artery to artery
*dissection (internal carotid, vertebral)
*paradoxial (PFO)
What are some causes of stroke in the young?
*hypercoagulable states
A fib increased the risk of stroke by how many fold?
What are the divisions of the MCA?
superior div., inferior div., deep territory (lenticulostriates), stem
What signs are typical of a MCA stroke?
cortical signs (aphasia, neglect, visual field defects)
What is the workup of stroke?
*IVF, HOB flat, gentle BP control
*IV tPA (3hrs), IA tPA (6hrs.)
*antiplatelet tx
ASA, Plavix, or Aggrenox
*risk factor modification