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23 Cards in this Set
- Front
- Back
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Most generally classification of stroke
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hemorrhagic vs. ischemic
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Acute ischemic stroke include what 2 broad subtypes?
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- thrombosis
- embolism |
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What % of strokes are ischemic?
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85%
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What % of strokes are hemorrhagic?
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15%
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In general when is tPA given for stroke?
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within 3 hours of onset for ischemic stroke
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Is tPA FDA approved for use in ischemic stroke?
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yes
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7 general categories of treatment elements in acute ischemic stroke
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- supportive care
- treatment of neurologic complications - antiplatelet therapy - glycemic control - blood pressure control - prevention of hyperthermia - thrombolytic therapy |
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Estimated direct and indirect costs of stroke in US per year
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$43.3 billion
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3 macroscopic categories of pathophysiology of ischemic stroke
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- extracranial embolism
- intracranial thrombosis - decreased cerebral blood flow |
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Percentage of patients with MI that have an associated embolic stroke
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2-3%
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What time frame is the highest risk of embolic strokes as a complication of MI and what % happen during this time?
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85% in the 1st month
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General subdivision of types of thrombotic strokes
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- large vessel (carotids)
- small vessel (circle of willis, posterior circulation) |
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Anatomically, the most common site of thrombotic occlusion for CVA
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cerebral artery branch points, especially in internal carotid
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7 common underlying causes of thrombosis formation leading to ischemia stroke
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- ruptured plaque
- polycythemia - sickle cell anemia - protein C deficiency - fibromuscular dysplasia of the cerebral arteries - prolonged vasoconstriction from migraine - dissection |
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Describe the ischemic cascade of ischemic stroke
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Loss of oxygen causes depleted O2 -> depleted ATP -> membrane depolarized -> calcium leaks in -> excitotoxicity from neurotransmitter release (self perpetuating) -> free radical formation -> gene activation that increases inflammatory cytokines
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Central goal of therapy in acute ischemic stroke
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preserve the area of oligemia in the ischemic penumbra
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Main excitatory receptor involved in excitotoxicity after ischemic stroke
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NMDA
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2 major ways to preserve the area of oligemia after ischemic stroke
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- limiting severity of injury (neuronal protection)
- reducing duration of ischemia |
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Incidence of first time strokes in the US
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400,000 per year
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Stroke is the ___ leading cause of death in the US
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3rd
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Stroke is the ___ leading cause of disability in the US
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1st
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General gender influence on ischemic stroke
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- more common in men
- women respond better to tPA |
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What % of strokes occur in patients under the age of 65?
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25%
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