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21 Cards in this Set
- Front
- Back
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what are some symptoms of a stroke?
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- sudden blurred vision, numbness, weakness
- sudden difficulty speaking, loss of balance, headache |
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what are 75% of all strokes?
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- ischemic strokes
- either lacunar, thromboembolic, cardioembolic or unknown |
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what happens in a lacunar stroke?
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- small blood vessels in brain become blocked because become increasingly narrowed over many years
- thrombus may form leading to complete occlusion |
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what types of strokes are common in people with HTN, diabetes & HBP?
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- lacunar strokes
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what is the definition of a stroke?
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- sudden onset neurological deficit in a vascular territory
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what is lipohyalinosis?
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- see in lacunar strokes, narrowing of lumen b/c of thickening of blood vessel
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what are the sources of emobli?
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- artery-to-artery (carotid, aorta, etc)
- cardiac source (intracardiac thrombosis) - paradoxical (PFO) |
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what happens with decreased perfusion through a fixed stenosis?
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- narrowed artery, drop in BP decreases flow to vessel now artery cannot sufficiently perfuse its territory
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what is the new definition for TIA?
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- less than 1 hr, no evidence of acute infarction
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what does a transcranial ultrasound tell you?
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- can look at orbit, squamout part of temporal bone & foramen magnum
- know wave forms for arteries so get a sense of who is blocked or at risk |
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what does T2 vs DW MRI tell you?
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- T2 can't see ischemia until around 24 hours after where as DWI tells you within minutes
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what is the diffusion/perfusion mismatch?
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- although there is infarction there is also another larger area not being perfused
- this is the territory at risk - if we can restore this we can salvage other at risk tissue |
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what happens if diffusion & perfusion matvch?
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- you do not really want to treat this aggressively because the tissue that has infarcted is what was going to be gone anyways
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what can an angiogram help you with?
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- will help you identify atherosclerosis
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what is the ischemic penumbra?
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- difference b/w core infarcted area & penumbra is the salvagable tissue
- difference in perfusion vs diffusion |
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what are strategies for acute stroke treatment?
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- revascularization: plumbing approacvh - TPA
- preventing damage from ischemic cascade (protecting ischemic neurons from dying) |
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when can you give TPA?
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- within 3 hours of onset
- earlier the better |
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what is a risk of giving TPA?
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- bleeding is frequent complication of ischemic stroke
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what are neuroprotectant agents? why are they not used in humans yet?
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- they block neurotoxicity from Ca influx
- not used in humans yet because they have only been successful in animal models |
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why would you not treat HTN in patient with suspected stroke?
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- because want to keep HBP to perfuse the areas
- this is because autoregulation of brain is failing |
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what is FAST?
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- face, arms, speech, time is brain
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