Neuro

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Author:
jessiekate22
ID:
181397
Filename:
Neuro
Updated:
2012-11-03 02:17:32
Tags:
Intro Stroke
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Continued
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  1. What is the % of strokes that are haemorrhagic strokes?
    - 10-15% of all strokes (caucasians)
  2. What is a haemorharrgic stroke caused by?
    caused by rupture of an intracerebral artery
  3. What parts does a haemorhagic stroke happen in?
    • - subarachnoid
    • - subdural
  4. What are some predisposing factors of haemorrhagic stroke?
    • - AVM (arterial venous malformation)
    • - degenerative small vessel disease- lifetime
    • - amyloid angiopathy
    • - HT
    • - coagulation disorders- hemophillia
    • - cocaine and amphetamines
    • - tumour
  5. Where is atherosclerotic plaque more likely to happen?
    • - where arteries bifucate
    • - where increase BP
  6. What are the clinical effects of a supratentorial haematoma?
    • - same ase classic ischemic stroke
    • - sudden headache and LOC (mss effect) over 24-48 hrs
    • - focal signs eg hemiparesis, hemisensory loss, homonymous hemianopia
    • - usually get a splitting headache
  7. what aree the clinical effects of cerebellar haematoma?
    • - sudden onset of headache
    • - cerebellar and brainstem signs and symptoms: ataxia, vertigo, vomiting, dizziness
    • - CSF obstruction can lead to hydrocephalus with signs and symptoms of increase inter cranial pressure
  8. What is a pontine haemotoma?
    • - sudden loss of consciousness. Resp irregularities, pyrexia
    • - quadriplegia, pin point pupils, skrewed eye movements
    • - death commonly follows
  9. ICH= intracerebral haemorrhagic stroke
    • - they are dynamic
    • - where blood doesnt get it suffers from hypoxia
  10. What is a SAH?
    saccular anneurysm
  11. Who gets SAH?
    • - younger pop due to genetic abnormalities
    • 5% of all strokes
  12. What causes a SAH?
    • - ruptured saccular aneurysm- 85%
    • - arterial dissection- < 5%
    • - hypertensive complex small vessel disease
  13. WHat is the surgical management of SAH and ICH?
    • - SAH- repair aneurysm to prevent rebleed
    • - ICH- drain haemotoma to relieve mass effect and reduce ICP. Excise AVM if present
  14. stroke
  15. What is a TACI?
    • - total anterior cerebral infarct (can be syndrome, haemorrhage)
    • - hemiparesis or hemisensory loss
    • - visual distrubances and glbal aphasia
    • - aphasia is when dom hemisphere is affected if not you will have spatial neglect
  16. WHat is a PACI?
    • partial ant circulation infarct
    • - 2/3 parts of TACI
    • - dysphasia typically expressive or receptive
    • - typically no drowsiness
  17. What is a POCI?
    • - posterior circulation infarct
    • - ipsilateral cranial nerve alsies with contralateral sensory/ motor loss
    • - vestibular or occular signs
    • - isolated cerebellar dysfunction- ataxia/ coordination
    • - isolated homonmous heminopia- loss of vision of one side on both eyes
    • - visual disturbances
  18. What is a LACI?
    • - discrete symptoms
    • - pure motor stroke
    • - pure sensory stroke
    • - ataxic hemiparesis
    • - dysarthria or clumsy hand syndrome
    • - isolated to face and hand
  19. stroke types info
  20. Your chances of surviving a stroke decrease with?
    • - lesion size
    • - prolonged unconsciousness
    • - increased age
    • - severe hyptertension
    • - severe co-existing disease- heart disease
    • TACIS and ICH = bad
  21. What are the stroke outcomes at the end of the first year?
    • - 30% dead
    • - 30% another stroke

    • of survivours
    • 60% will need helps ADLs
    • 5% are totally I
    • 30% of working age will return to work
  22. What causes death?
    • - effects of ICP in ICH
    • - Infection esp aspiration pneumonia
    • - venous thromboembolism

    • the best outcomes for stroke survivors are achieved by preventing complications
    • 1st 48hrs

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