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14 Cards in this Set

  • Front
  • Back
What are the 4 mechanisms of ischemic stroke syndrome?
1. large-artery atherosclerosis
2. penetrating-artery disease
3. cardiogenic emoblism
4. unusual causes
In large-artery atherosclerosis, what are the 2 ways of causing a stroke?
1. hemodynamic (flow) compromise -> thrombotic occlusion
2. Artery to Artery embolism -> piece of thrombus breaks off and blocks flow distally
1. What are risk factors for penetrating-artery disease?
2. treatment?
1. age, HTN, diabetes
2. antiplatelet - aspirin, etc.
Most common cause of cardiogenic embolism?
nonrheumatic atrial fibrillation
1. If you have high index of suspicion of A. fib, how do you evaluate pt?
2. treatment?
1. TEE
2. anticoagulating with warfarin
most common clinical presentation of lacunar infarcts?
pure sensory or pure motor defects
what are some unusual causes of stroke?
1. drug-induced -> cocaine, amphetamines
2. dissection of blood vessel
3. sinus venous thrombosis
4. migraine
5. hematologic - sickle cell, antiphospholipid antibody
if someone comes into ER with amaurosis fugax, what is the next thing you should do?
carotid ultrasound, MRI
What symptoms will you see with Carotid territory TIA?
1. unilateral weakness
2. unilateral sensory symptoms
3. difficulty speaking - aphasia, dysarthria
4. amaurosis fugax
what symptoms will you see with Vertebrobasilar territory TIA?
1. bilateral weakness
2. bilateral sensory symptoms
3. 5 D's -> Diplopia, Dizziness, Dysarthria, Ataxia (dysequilbirium), Dysphagia
Middle Cerebral Artery Stroke
1. due to?
2. symptoms
1. atherosclerosis or cardiogenic embolism
2. contralateral hemiparesis and sensory loss (face, arm, hand worse than leg), contralateral hemianopsia and either aphasia or neglect
For each, list what area of brain it supplies and the symptoms:
1. ACA stroke
2. PCA stroke
1. supplies medial surface; contralateral leg weakness and numbness
2. supplies occipital cortex; contralateral hemianopia w/ macular sparing
What do you see with brainstem strokes?
1. ipsilateral cranial nerve deficit w/ contralateral motor and/or sensory loss
2. often have bilateral weakness and numbness
Lateral Medullary Stroke
1. vessels?
2. symptoms?
1. PICA or vertebral artery
2. contralateral loss of pain/temp - spinothalamic tracts
2. ipsilateral dysphagia - nucleus ambiguous
2. hoarseness and decreased gag -""
2. vertigo/nystagmus w/ nausea/vomiting
etc....