Term
| TIAs are a symptom or a specific disorder? |
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Definition
| TIAs are only a symptom of a dz. |
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Term
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Definition
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Term
| If a TIA lasts longer than 30 minutes, then it is usually: |
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Definition
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Term
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Definition
| Transient deficit lasting more than 24 hours, but clearing completely in a few days. Reversible Ischemic Neurological Deficits. |
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Term
| How many pts with hx of TIA will have a stroke within 3 years, and how many in 5 years? |
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Definition
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Term
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Definition
| amaurosis fugax, transient aphasia, motor or sensory in single extremity "bear's paw," contralateral ocular bruit, ipsilateral Hollenhorst & rare Horner's |
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Term
| Sx of vertebrobasilar TIA |
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Definition
| aphasia, dizziness, diplopia, ataxia, syncope, loss of conciousness, dysphagia (swallowing), numbness in face/lips, hemiparesis or hemisensory loss, or bilateral motor or sensory deficits. |
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Term
| Subclavian steal syndrome |
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Definition
| left arm "steals" blood from the basilar by way of vertebral. Causes vertebrobasilar insufficiency. Rarely stroke. |
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Term
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Definition
| Commonly cause TIAs with different presentations each time. |
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Term
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Definition
| emboli, cardiac arrhythmias, hypotension |
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Term
| Lancet ABCD scoring system for TIA |
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Definition
Age, blood pressure, clinical features, duration:
Age >60, weakness one side, difficulty speaking, >1 hour, >10min but <1 hour
If score of 6 or greater,stroke risk is 31% - call PC for referral <24 hours. |
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Term
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Definition
| General term for sudden onset focal neurologic deficit caused by vascular disease lasting at least 24 hours and usually past 72 hours. |
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Term
| Sx of thrombotic large vessel stroke |
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Definition
HA common (if ant, HA behind eyes; if post, HA over occipital)
Warnings precede onset by days/weeks
Onset sleep or inactive. |
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Term
| Sx of thrombotic small vessel stroke |
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Definition
Lacunar stroke: very small area of infarct.
Pure motor or pure sensory
Clumsy-hand dysarthria
Common in HTN and DM
HA rare
Onset asleep or inactive |
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Term
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Definition
Occur during sleep or inactivity
Signs and symptoms progress step-wise |
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Term
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Definition
| vertigo, diplopia, nausea, "hiccups," Horner's, pain over eye, facial numbness |
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Term
| Brainstem syndrome (thrombotic strokes) |
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Definition
Pons - usually fatal
Medial pons - weakness/internuclear ophthalmoplegia or gaze palsy |
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Term
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Definition
CN 3
ipsilateral pupil dilation, ptosis, ophthalmoparesis,
contralateral hemiplegia |
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Term
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Definition
cardiac = 15-20%
Often during waking hours with no warning
Display max deficit at onset. May improve in hours. |
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Term
| Intracerebral hemorrhage storke |
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Definition
"primary htn hemorrhage"
Almost always secondary to sustained elevated SBP
Onset awake and active
No prodrome
50% severe HA with development |
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Term
| Putaminal intracerebral hemorrhage |
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Definition
eyes deviate to side of lesion
pupils normal size and reactive |
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Term
| Thalamic intracerebral hemorrhage |
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Definition
eyes deviate down to nose; no vertical gaze.
Pupils small and nonreactive |
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Term
| Pontine intracerebral hemorrhage |
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Definition
eyes mid-position, positive "doll's eyes" with ocular bobbing.
Pupils pin-point but reactive to light |
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Term
| Cerebellar intracerebral hemorrhage |
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Definition
eyes mid-position, difficulty to side of lesion, or CN 6 palsy.
Pupils normal size and reactive. |
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Term
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Definition
Not a stroke
"worst HA of life"
Stiff neck and photophobia
Altered consciousness
Bloody CSF
vomiting, fever, seizures |
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Term
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Definition
M >45, F > 55
FHx
AA, H, A race
smoking
BP over 140/90
Overweight by 20 lbs (BMI >30)
Physical activity <30 day
DM
Cholesterol 240
HDL <35 mg/dL
MHx of TIAs, carotid artery dz, CHD, atrial fib, MI, peripheral vessel dz, or HCT >60% |
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Term
| Risk factors for stoke in young adults |
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Definition
| HTN, oral contraceptives, hypercoaguable states, cocaine abuse, binge ETOH, amphetamines |
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Term
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Definition
| 160/90 (helps with ischemic areas) |
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Term
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Definition
Can not tell true extent for 3 days
Some but little improvement 3 weeks
At 3 mos, can estimate improvement
3 mos later (S/P 6 mos - 90% recovery
Up to 18 mos - will gain another 10% recovery |
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Term
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Definition
NOT a stroke.
Blood flow is inadequate to meet metabolism needs
Most secondary to cardiac arest |
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Term
Global cerebral ischemia
Brief ischemic episode: |
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Definition
Coma <12 hours
transient confusion or amnesia
Complete recovery in 7-10 days to 1 month |
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Term
Global cerebral ischemia
Prolonged ischemic episode:focal cerebral dysfunction |
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Definition
Coma <12 hours
Lasting focal motor, sensory and cognitive deficits if awaken
Full recovery may not occur for months. |
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Term
Global cerebral ischemia
Prolonged ischemic episode: persistent vegetative state |
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Definition
Awaken after coma but are unaware of surroundings: eye opens and moves, sleep/wake cycles, brain & spinal reflexes.
Not flat EEG with neocortical death. |
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Term
Global cerebral ischemia
Prolonged ischemic Episode: Spinal cord syndromes |
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Definition
Impairment of pain/temperature
Produces flaccid paralysis at 1st, then spastic paraplegia with brisk tendon reflexes. |
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