Exam 2: Stroke, CVA, TIA
Cerebrovascular Disease Examples - Answer -TIA
-Stroke
-Aneurysms
What are the residual effects of TIA? - Answer No residual effects, but there is an
increased risk for stroke going forward (esp. in first month after stroke)
Males more!
What is a TIA? - Answer Transient Ischemic Attack
-acute, focal cerebral
-insufficiency that lasts less than 24 hours
What is Bell's Palsy? - Answer facial nerve paralysis d/t inflammation on nerve
--not as much issues with speech
Can last days to weeks (TIA = less than 24 hours)
What is the difference between TIA and Bell's Palsy? - Answer TIA
-lasts less than 24 hours
Bell's
-lasts days to weeks
CM of TIA - Answer -dysphagia
-weakness
-numbess
-vertigo
-motor and sensory changes
-vision loss
Dysphagia vs. Dysphasia - Answer Dysphagia
-difficulty swallowing
Dysphasia
-difficulty speaking
What is contralateral? - Answer opposite side
What is ipsilateral? - Answer same side
Dx of TIA - Answer -hx and physical
, Imaging
-CT/MRI/MRA: r/o hemorrhage, infarcts, aneurysms
-Carotid Doppler: Look for stenosis, blockages with plaque (PE risk!), and bruit.
-Echocardiogram: assess for cardiac source like vegetation on valves (patent foramen
ovale allows vegetation to get to L ventricle).
What is an angiogram? How relevant to TIA? - Answer X-ray pictures of blood vessels.
Shows damage to brain tissue.
Tx for TIA - Answer Depends on Cause
-anticoagulation (ASA)
-clopidegrel (Plavix)
-heparin and warfarin if A-fib
Surgery
-carotid endarterectomy with >70% stenosis
-carotid angioplasty with filter
What is clopidegrel (Plavix) used for? - Answer antiplatelet drug
Why is a filter needed with carotid angioplasty? - Answer to catch the clots as they are
broken up
What is a stroke/CVA? - Answer Acute, focal cerebral insufficiency (problem with blood
supply to the brain) that lasts over 24 hours.
--results in lasting neurological deficits
What are the types of cerebrovascular accident? - Answer -ischemic
-hemorrhagic
What are the types of ischemic stroke? - Answer -thrombotic & embolic
-hemorrhagic
What is a thrombotic/embolic stroke? - Answer Type of Ischemic Stroke
Thrombotic
-atherosclerosis in area plus hyper-coagulable state leads to occlusion of cerebral artery
which impedes blood flow
Embolic
-MURAL THROMBUS
-something moves from peripheral circulation (thrombus from atria, vegetation on heart
valve) to the brain and gets stuck
Etiology of thrombotic ischemic stroke - Answer -atherosclerosis in area
-hyper coagulable state leads to abnormal clotting
Cerebrovascular Disease Examples - Answer -TIA
-Stroke
-Aneurysms
What are the residual effects of TIA? - Answer No residual effects, but there is an
increased risk for stroke going forward (esp. in first month after stroke)
Males more!
What is a TIA? - Answer Transient Ischemic Attack
-acute, focal cerebral
-insufficiency that lasts less than 24 hours
What is Bell's Palsy? - Answer facial nerve paralysis d/t inflammation on nerve
--not as much issues with speech
Can last days to weeks (TIA = less than 24 hours)
What is the difference between TIA and Bell's Palsy? - Answer TIA
-lasts less than 24 hours
Bell's
-lasts days to weeks
CM of TIA - Answer -dysphagia
-weakness
-numbess
-vertigo
-motor and sensory changes
-vision loss
Dysphagia vs. Dysphasia - Answer Dysphagia
-difficulty swallowing
Dysphasia
-difficulty speaking
What is contralateral? - Answer opposite side
What is ipsilateral? - Answer same side
Dx of TIA - Answer -hx and physical
, Imaging
-CT/MRI/MRA: r/o hemorrhage, infarcts, aneurysms
-Carotid Doppler: Look for stenosis, blockages with plaque (PE risk!), and bruit.
-Echocardiogram: assess for cardiac source like vegetation on valves (patent foramen
ovale allows vegetation to get to L ventricle).
What is an angiogram? How relevant to TIA? - Answer X-ray pictures of blood vessels.
Shows damage to brain tissue.
Tx for TIA - Answer Depends on Cause
-anticoagulation (ASA)
-clopidegrel (Plavix)
-heparin and warfarin if A-fib
Surgery
-carotid endarterectomy with >70% stenosis
-carotid angioplasty with filter
What is clopidegrel (Plavix) used for? - Answer antiplatelet drug
Why is a filter needed with carotid angioplasty? - Answer to catch the clots as they are
broken up
What is a stroke/CVA? - Answer Acute, focal cerebral insufficiency (problem with blood
supply to the brain) that lasts over 24 hours.
--results in lasting neurological deficits
What are the types of cerebrovascular accident? - Answer -ischemic
-hemorrhagic
What are the types of ischemic stroke? - Answer -thrombotic & embolic
-hemorrhagic
What is a thrombotic/embolic stroke? - Answer Type of Ischemic Stroke
Thrombotic
-atherosclerosis in area plus hyper-coagulable state leads to occlusion of cerebral artery
which impedes blood flow
Embolic
-MURAL THROMBUS
-something moves from peripheral circulation (thrombus from atria, vegetation on heart
valve) to the brain and gets stuck
Etiology of thrombotic ischemic stroke - Answer -atherosclerosis in area
-hyper coagulable state leads to abnormal clotting
