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23 Cards in this Set

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