NS: Stroke
Terms
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- when is the maximal deficit from a stroke experienced?
- within a few minutes after the event.
- a defect in the ability to produce or understand language
- aphasia
- pins and needles?
- parasthesia
- the preferred diagnostic imaging tool for a suspected stroke patient
-
CT scan
quick (time is important)
detects hemorrhage well (Fe in blood)
requires little patient cooperation - what type of MRI is used for stroke patients?
-
T2-weighted MRI
returns a tissue/water signal
easily identified lesions
NOT good for determining acute treatment
good for a post-hoc inspection - why is cerebral angiography risky?
-
risk of stroke
risk of kidney failure (dye) - symptoms of a stroke?
-
loss or diminished consciousness
facial weakness
headache (esp. hemorrhagic)
aphasia
ataxia
paralysis, sensory loss of one side of body
unilateral diminished coordination
weawkness - 2 types of strokes
-
ischemic - reduced blood supply
-focal
-global
hemorrhagic - bursting of a cerebral vessel
ex. hypertension and aneurisms - 2 types of ischemic strokes
-
focal ischemia - occlusion of a vessel. downstream brain tissue is affected
global ischemia - the whole body isn't getting enough blood but the brain is affected most.
ex. cardiac arrest, pulmonary embolism - floating disaster
- embolus
- stationary disaster
- thrombus
- where do thrombi most often occur?
- branch points of arteries
- which is worse, intracranial or subarachnoid hemorrhage?
-
intracranial!!
hard to reach surgically. - why do hemorrhagic strokes present w/ strong headaches?
- pressure on nerve endings in meninges
- lacunar stroke?
- small vessel is occluded and infarction creates a lacune (cavity) in brain (5-10mm)
- why do stroke survivors have cavities in their brain?
- macrophages remove necrotic neurons from the infarct.
- what are top 3 risk factors for stroke?
-
1. age
2. hypertension
3. heart disease