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28 Cards in this Set
- Front
- Back
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What is the most common type of stroke?
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Ischemic
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What is small vessel disease most often attributed to?
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Hypertension
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What is a stroke?
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Sudden neurological dysfunction due to a vascular cause
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Describe the four subtypes of occlusive strokes (include origin/cause).
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Cardioembolic (strokes of cardiac origin; includes atrial fibrillation, valvular heart dz)
Small vessel dz (strokes due to occlusion of vessels; often due to HTN, DM) Large Vessel Dz (occlusion of vessels 1-4mm; carotid, MCA; due to high chol) Rare and UNK (stroke due to arterial dissection--tear--blood coagulation abnormality) Each accounts for about 25% of ischemic stroke. |
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FLAIR Image showing strokes over lifetime
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About what percent of strokes are hemorrhagic? Cause?
Describe the two subtypes (include causes, location). Which is more prevalent? |
10% of all strokes are hemorrhagic (much more lethal than ischemic stroke)
Due to vessel rupture (40% mortality) 1) Lobar hemorrhage (75%): HTN, deep structures (putamen, basal ganglia) Amyloid angiopathy (superficial, older) Arteriovenous malformation (superficial, younger) 2) Subarachnoid Hemorrhage (about 25%): aneurysm, arteriovenous malformation |
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Signs of a Left Middle Cerebral Artery stroke?
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Aphasia
Right Hemiparesis (weakness): face/arm more than leg Deviation of eyes to LEFT Right hemianesthesia (sensory loss) Right hemianopia (right visual field loss) |
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Signs of a Right Middle Cerebral Artery stroke?
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Neglect
Left hemiparesis (weakness): face/arm more than leg Deviation of eyes to RIGHT Left hemianesthesia (sensory loss) Left hemianopis (loss of left visual field) |
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Broca's vs Wernicke's Aphasia
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Broca: no expression, writing, repetition or naming; COMPREHENSION and READING INTACT
Wernicke's: No comprehension, reading, writing, repetition, naming; EXPRESSION INTACT (word salad) |
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Signs of Global Aphasia
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No expression, comprehension, reading, writing, repetition, naming
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Transcortical Motor vs Transcortical Sensory Aphasia
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Trans Motor (Broca's with reptetition intact): no expression, writing, naming; Comprehension, Reading, Repetition intact
Trans Sensory (Wernicke's with repetition intact): No comprehension, reading, writing, naming; Expression and repetition intact |
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Signs of Conduct Aphasia
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Can't repeat but expression, comprehension, reading, writing, and naming intact
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Signs of Alexia-Agraphia Aphasia
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Can't read; expression, comprehension, writing, repetition, naming intact
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Signs of a Lacunar Stroke
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One sided weakness without aphasia or neglect
Brainstem lacunes may have crossed findings |
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Signs of Weber Lacunar Stroke
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3rd Nerve Palsy
Contralateral hemiparesis (midbrain) |
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Signs of Benedikt Lacunar Stroke
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3rd Nerve Palsy
Contralateral dysmetria (pons) |
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Signs of Millard-Gubler Lacunar Stroke
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CN 6 + 7 palsy (facial weakness)
Contralateral hemiparesis (pons) |
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If patient has a one-sided ptosis but is able to converge eyes, what is diagnosis?
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Internuclear ophthalmoplegia (not a 3rd nerve palsy because can converge eyes)
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______ strokes are NOT associated with aphasia
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Lacunar
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In a patient with atrial fibrillation and stroke, what is the treatment of choice for secondary stroke prevention?
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Warfarin
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A patient with left MCA stroke had 75% stenosis on the left internal carotid. What is the best treatment to prevent a stroke over the next 2 years?
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Carotid endarterectomy
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What is the timeframe for tPA wadministration? ASA?
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tPA within 4.5 hours
ASA within 48 hours |
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Describe the ABCDE treatment plan for stroke.
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Antiplatelets (ASA, Aggrenox, Plavix)
Anticoag (Warfarin) Blood Pressure Control (less than 140/90) Carotid Artery Repair (if more than 70% narrowing) Cholesterol Lowering Cessation of Smoking Diet Exercise |
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What are MCA strokes typically associated with (that differentiate them from other strokes)?
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Aphasia and Neglect
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