Neuro - 5 - Stroke management

1

100

What (4) systems are involved with stroke? 

1. MSK
2. Integumentary
3. Pulmonary
4. Cardiovascular 

200

With this kind of stroke, the deficits are more severe. 

Hemorrhagic 

300

Name the management category: 

Age less than 45 

Young stroke 

400

Name the type of pharmacological management: 

Control HTN (EX: beta blocker) 

Antihypertensive agents ** 

500

- ACA syndrome
- MCA syndrome
- Internal carotid artery syndrome
- PCA syndrome
- Lacunar stroke
- Vertebrobasilar artery syndrome 

Vascular syndromes 

2

100

- 5th leading cause of death
- Leading cause of long-term disability in adults in US
- Women lower risk until over 85 then assume higher risk than men
- Highest in African Americans, Mexican Americans, American Indians, Alaskan Natives 

Epidemiology and etiology 

200

Name the management category: 

Stable, severe impairments 

Major stroke ** 

300

Name the type of pharmacological management:

Ischemic stroke management, clot buster, can be given within the first 2-3 hours after onset of symptoms 

Thrombolytics -- Tissue plasminogen activator (tPA) ** 

400

What does the FAST acronym stand for? 

F - Face drooping
A - arm weakness
S - speech difficulty
T - time to call 911 *** 

500

What is the most common site of occlusion in stroke? 

MCA 

3

100

Which type of stroke: 

thrombosis, embolism, hypoperfusion 

Ischemic 

200

Name the management category:

Symptoms no greater than 24 hours ** 

Transient ischemic attack ** 

300

Name the type of imaging:

Acute phase of stroke, most readily available; ischemia or hemorrhage rule out (tells you which one it is), first line of action when patient comes to ER 

Computed tomography (CT) 

400

Managed BP, healthier diet, cholesterol, exercising, obesity, smoking 

Modifiable risk factors 

500

Possible deficits:
- Contralateral sensory loss or central poststroke thalamic pain
- Homonymous hemianopsia, visual agnosia, prosopagnosia, or if bilateral cortical blindness
- Amnesia
- Wide variety of effects in subthalamic structures involved
- Contralateral hemiplegia 

Posterior cerebral artery syndrome 

4

100

TIA, minor stroke, major stroke, deteriorating stroke, young stroke 

Management categories

200

Name the management category: 

Neuro status worsens after admission, not stable, (same as progressive stroke) 

Deteriorating stroke ** 

300

Name the type of pharmacological management: 

Thin blood to reduce clotting risk and prevent existing clots from expanding (EX: Heparin) 

Anticoagulants ** 

400

Possible deficits: 

Contralateral hemiparesis and sensory loss with greater involvement of the LE than the UE because the somatotopic organization of the medial aspect of the cortex includes the functional area for the LE 

Anterior cerebral artery syndrome 

500

Possible deficits:
- Produces massive infarction in the region of the brain supplied by the MCA
- Supplies both the MCA and ACA. If collateral circulation to the ACA from the circle of willis is absent, extensive cerebral infarction in the areas of both the ACA and MCA can occur. Significant edema is common with possible uncal herniation, coma, and death 

Internal carotid artery syndrome 

5

100

Which type of stroke: 

Rupture, bleed 

Hemorrhage 

200

Name the management category: 

Stable, minimal impairments 

Minor stroke *** 

300

Name the type of imaging: 

Increased sensitive, contraindicated with pacemakers 

Magnetic resonance imaging (MRI) 

400

Name the type of pharmacological management: 

Prevents clumping of platelets (EX: aspirin) 

Antiplatelet therapy ** 

500

 Possible deficits:
- contralateral spastic hemiparesis and sensory loss of the face, UE, and LE with the face and UE more involved than the LE
- Aphasia
- Perceptual deficits (EX: unilateral neglect, anosognosia, apraxia, and spatial disorganization)
- Homonymous hemianopsia is also a common finding 

Middle cerebral artery syndrome