Patho 3

Card Set Information

Author:
cgordon05
ID:
16703
Filename:
Patho 3
Updated:
2010-04-28 21:03:18
Tags:
Neuro stroke
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Description:
Neuro - stroke
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  1. Thrombotic stroke
    (p.2-3)
    • More common than embolic
    • Occur in small and large arteries
    • Obstruction of blood flow in artery due to pathological process within that artery
    • Can occur over time as plaque forms
  2. Embolic stroke
    (p.2-3)
    • Caused when blood clots or atheromatous debris form outside the brain and become lodged in cerebral circulation
    • Can lodge in small vessels
    • At risk = pt with plaque formation, a-fib, valvular heart disease, coronary heart disease, cardiomyopathy
  3. Hemorrhagic stroke
    (p.2-3)
    • 20% of strokes
    • Occurs when blood vessel supplying brain ruptures
    • Clot expands, causes pressure on brain tissue, surrounding rim of clot becomes ischemic
  4. Subflow states
    (p.2-3)
    • Too little blood flow to brain
    • Blood clot (thrombus) - originating within brain
    • "Traveling" blood clot (embolus) - from outside the brain
    • Thrombus or embolus impedes/stops blood flow of involved vessel
    • Result = cerebral infarction
  5. When is tPA contraindicated for a patient with ischemic stroke? (15)
    (p.61)
    • 1) symptoms minor or rapidly improving
    • 2) seizure at stroke onset
    • 3) stroke or head trauma in past 3 months
    • 4) major surgery within past 14 days (2 weeks)
    • 5) Hx of ICH
    • 6) Sustained SBP > 185 mmHg
    • 7) Sustained DBP > 100 mmHg
    • 8) aggressive treatment to lower BP
    • 9) symptoms suggesting SAH
    • 10) GI or GU hemorrhage in past 21 days (3 weeks)
    • 11) arterial puncture at noncompressible site in past 7 days (1 week)
    • 12) received heparin in past 48 hours AND elevated PTT
    • 13) PT > 15 seconds or INR > 1.7
    • 14) Platelets < 100,000 uL
    • 15) serum glucose < 50 or > 400 mg/dL
  6. What is the usual cause of subarachnoid hemorrhage?
    (p.6)
    • Ruptured cerebral aneurysm
    • When aneurysm ruptures, blood enters subarachnoid space encircling brain
    • --> increased ICP
    • --> blood acting as irritant to brain generating vasospasm
  7. How would patient typically describe the headache associated with SAH?
    • "Worst headache of my life"
    • Sudden, intense, un-distinct location or quality, different than previous headaches
    • Can be followed by transient LOC

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