Ischemic Stroke
HTN, afib, diabetes, dyslipidemia, and inactivity
What at modifiable risk factor for ischemic stroke?
Most common cause overall of hemorrhagic stroke
What is HTN?
LOC, lucid interval, and fast decompensation
What is an epidural hematoma?
Indication for tPA?
What is onset of stroke symptoms within the past 3 hours and no hemorrhage on imaging?
What is the reticular activating system?
Penumbra
What is the area at risk of infarction if ischemia is not addressed?
Most common presentation of a hemorrhagic stroke resulting in SAH?
What is a thunderclap headache?
Type of bleed more common in alcoholics, elderly, and infants
What is a subdural hemorrhage?
Craniectomy
Three most common causes of altered levels of consciousness
What are intoxication, stroke, and trauma?
Occlusion leads to contralateral hemiparesis, sensory deficit of face and arm with global aphasia
What is the MCA?
Confirmatory test for one kind of hemorrhagic stroke while life-threatening procedure for another kind
What is a lumbar puncture?
Most likely diagnosis based on visualizaiton of hyperdensities following sulci and gyri on non-contrast head CT
What is asubarachnoid hemorrhage?
Indication for vascular coiling or surgical clipping of an unruptured cerebral aneurysm
What is size > 10 mm?
Unresponsive to all external stimuli an internal needs with preserved reflexes
What is a comatose patient?
Occlusion of these large arteries bilaterally results in cortical blindness
What are the PCAs?
Site of hemorrhagic stroke that causes contralateral hemiparesis, facial droop, slurred speech and gaze in the direction of the bleed before ending with coma
What is the putamen?
Indication for surgical intervention of traumatic brain bleed
Reason for prescribing anxiolytics, stool softners, and analgesics in a patient with a hemorrhagic stroke
What is to prevent HTN-associated bleeding?
Criteria for declaring brain death (4)
What are cause of altered consciousness identified, sufficient time for meds to wear off (>5 half lives), normothermia, and correction of all electrolyte, BP, acid-base, and endocrine abnormalities?
Occlusion of this vessel leads to vertigo, double vision, circumoral numbness, abducens n. palsy, and hemiplegia. Often preceded by TIAs
What is the basilar artery?
Definitive treatment for hemorrhagic stroke caused by ruptured berry aneurysm
What is surgical clipping (or coil embolization) within 2 days of the bleed?
Intraparenchymal contusion present where brain impacts skull and then bounces off the cranium as it returns to normal position
What is a coup-coutracoup injury?
Step that should be performed prior to initiation of aspirin and clopidogrel following an ischemic stroke
What is a non-contrast head CT to rule out hemorrhagic conversion?
Preserved function in a patient with locked-in sydrome
What is voluntary eye movement?