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Flashcards in Stroke, HA, HTN Deck (112)
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1

Stokre sxs

• Symptoms vary – location dependent
• Weakness/numbness face/limbs, one side
• Confusion, difficulty speaking/understanding
• Agitation, seizure
• Vision changes – one/both eyes, visual field cut
• Difficulty walking, ataxia, loss of coordination

• Dizziness, vertigo, loss of balance

• Atraumatic loss of consciousness (did they have a seizure? Did they faint? Did they have a stroke?)

• Sudden, severe headache

2

VA changes associated with stroke

visual periphery changes
difficulty seeing out of one eye

3

Sudden, severe headache would be associated with what type of stroke

hemorrhagic

4

RF for stroke (11) starting with number 1

• TIA or previous CVA (#1)
• HTN
• DM
• Atrial Fibrillation
• EtOH, IVDU, stimulants
• Atherosclerosis
• High cholesterol
• Sickle Cell
• Obesity/inactivity
• Tobacco
• Increasing age

5

hx that would contribute to RF

• Heredity
Family Hx of CVA
• Ethnicity
African Americans
Hispanic Americans
• Gender
Men > Women

6

women are at greater risk for

Women > for SAH

7

critical timing hx for stroke pt

1. When did symptoms begin?
Treatment is time dependent
When were you/they last normal?
2. Sudden or gradual onset?

3. What are the symptoms, exactly?

4. Symptoms persistent or transient?

5 are you on anticoagulants?

6. PMHx, meds, risk factors

7 . Trauma? Syncope? N/V?


8 . Headache??

what are out CI for TPA

8

what % of strokes are ischemic

1. ~85% of all strokes

9

gradual vessel occlusion is known as a

2. Thrombotic


Atherosclerosis, gradual vessel occlusion
b. Sx onset may be gradual, stuttering
c. May have hx TIA

no blood distal

10

Sudden occlusion; sudden, fixed deficit

embolic stoke

11

who has embolic strokes

A fib, atrial clot, endocarditis (

12

pts with a thrombotic strokes may have has

TIA

13

Types of hemorrhagic CVA

2. Intracerebral Hemorrhage
3. Subarachnoid Hemorrhage


THESE ARE 15% OF ALL STROKES

14

evens that made lead to hemorrhagic stroke

a. HTN --> really uncontrolled
b. Cocaine, Meth, stimulants
c. Aneurysm bursts open
d. Arteriovenous Malformation (AVM)

15

Tx for hemorrhagic stroke

a. ABCDE’s
b. Control BP carefully
c. Neurosurgical consult
d. Multi-detector CT angiography
e. NIHS will be greater than 20

16

Left is dominant hemisphere in what pts

a. All right-handed

b. 80% left-handed

17

what % of people are right hemisphere dominant

3. Right is dominant in 20% lefties

18

how to tell where a stroke is- two major possibilities

2. Anterior circulation CVA
3. Posterior circulation CVA

19

Anterior circulation CVA comes off of and includes

CC

i. Anterior Cerebral Artery
ii. Middle Cerebral Artery

20

Posterior circulation CVA is where in origin and includes what

a. Vertebral artery origin


i. Posterior Cerebral Artery
ii. Vertebrobasilar stroke
iii. Cerebellar stroke

21

motor differences seen with
anterior Circulation CVA

: Contralateral weakness (If R sided symptoms, then your bleed is on the left)
• Leg, foot symptoms> arm symptoms

22

Sensory differences seen with
anterior Circulation CVA

Contralateral deficit
• Leg sx’s > arm sx’s

23

Loss of frontal lobe control seen with anterior cerebral artery

• Personality change
• Perseveration
• Incontinence
• Gait disturbances
• Apraxia (you know you want to move the muscle but you cannot)


this is seen in anterior cerebral artery strokes

24

apraxia is

can’t perform tasks or follow commands even though they know the task and wish to follow the command. Several specific types

seen with loss of anterior cerebral artery

25

Most common area to get a stroke – bad if big/central

Middle Cerebral Artery

often in the corners of the middle cerebral artery

26

Motor deficits with middle cerebral CVA

Contralateral weakness
• Face/arms > legs
• Facial droop

27

sensory deficits with middle cerebral CVA



Contralateral deficit
• Arms > legs

28

if a pt has a CVA in the middle cerebral of dominant hemisphere

If affecting the dominant hemisphere: aphasia (either receptive or expressive

29

if a pt has a CVA in the middle cerebral of non dominant

Non-dominant: neglect (neglect that part of the body that is affected completely)

30

Middle Cerebral Artery see the eyes doing this

Eyes turned toward side of stroke --> common in MCA strokes that are large