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14 Cards in this Set
- Front
- Back
What are the 4 mechanisms of ischemic stroke syndrome?
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1. large-artery atherosclerosis
2. penetrating-artery disease 3. cardiogenic emoblism 4. unusual causes |
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In large-artery atherosclerosis, what are the 2 ways of causing a stroke?
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1. hemodynamic (flow) compromise -> thrombotic occlusion
2. Artery to Artery embolism -> piece of thrombus breaks off and blocks flow distally |
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1. What are risk factors for penetrating-artery disease?
2. treatment? |
1. age, HTN, diabetes
2. antiplatelet - aspirin, etc. |
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Most common cause of cardiogenic embolism?
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nonrheumatic atrial fibrillation
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1. If you have high index of suspicion of A. fib, how do you evaluate pt?
2. treatment? |
1. TEE
2. anticoagulating with warfarin |
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most common clinical presentation of lacunar infarcts?
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pure sensory or pure motor defects
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what are some unusual causes of stroke?
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1. drug-induced -> cocaine, amphetamines
2. dissection of blood vessel 3. sinus venous thrombosis 4. migraine 5. hematologic - sickle cell, antiphospholipid antibody |
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if someone comes into ER with amaurosis fugax, what is the next thing you should do?
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carotid ultrasound, MRI
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What symptoms will you see with Carotid territory TIA?
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1. unilateral weakness
2. unilateral sensory symptoms 3. difficulty speaking - aphasia, dysarthria 4. amaurosis fugax |
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what symptoms will you see with Vertebrobasilar territory TIA?
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1. bilateral weakness
2. bilateral sensory symptoms 3. 5 D's -> Diplopia, Dizziness, Dysarthria, Ataxia (dysequilbirium), Dysphagia |
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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 |
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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 |
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What do you see with brainstem strokes?
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1. ipsilateral cranial nerve deficit w/ contralateral motor and/or sensory loss
2. often have bilateral weakness and numbness |
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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.... |