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24 Cards in this Set

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What type of HTN has the highest risk of stroke associated with it?
Systolic is a high risk factor than diastolic
REAL duration of a TIA?
Less than one hour
Most common duration of TIA sx's?
5-10 minutes
What is the only FDA approved drug for strokes?
Tissue Plasminogen Activator
Mech of tPA?
cleaves plasminogen to plasmin.
plasmin dissolves clots
How long is the treatment window with tPA?
3 hours
Risks with tPA use?
6% risk of intracranial hemorrhage
What percent of stroke patients receive tPA in US?
2-5%
Why so low?
they don't always come in fast enough
AND
you have to have a neurologist consulting
What part of brain are we trying to save with acute stroke therapy?
Penumbra
What is another drug that may be good for strokes? why?
Minocycline
Its neuroprotective
What kinds of deficits do you get with a Middle Cerebral Artery Stroke?
Face and Arm > Leg
Aphasia
Neglect
Sensory Disturbances
What kinds of deficits do you get with a Anterior Cerebral Artery Stroke?
Leg > face and arm
Abulia
Sensation preserved
what is abulia?
lack of initiative
what is aphasia?
inability to speak. (think broca's)
What kinds of deficits do you get with a Lacunar Artery Stroke?
Pure Motor or Pure Sensory
No Aphasia or neglect
May contribute to dementia
how do you get the "locked in" state?
Pontine Infarction or Hemorrhage
Sx's of Locked In?
Conscious
Sensation preserved
Unable to move except for blinking
Prognosis for Locked In?
POOR
Another Cause of IPH I left out?
COCAINE
Rx of a Subarachnoid Hemorrhage
Nimodipine (for vasospasm)
Arteriogram
Embolization with Platinum Coils
CSF in Subarachnoid Hemorrhage
RBC
+
Xanthochromia (yellow)
How often are sentinel bleeds missed?
20-50% of the time
Complications with SAH? when do they happen?
Rebleed - first 24 hrs
Vasospasm - 4-14 days
Hydrocephalus