Chapter 15 Neurologic Emergencies

The principle difference between a patient who has had a stroke and a patient who has hypoglycemia almost always has to do with the:

The following conditions can mimic a stroke EXCEPT:
A. Hyperglycemia
B. A postictal state
C. Hypoglycemia
D. Subdural bleeding

Stroke is the ____ leading cause of death in the United States.

More ____ than ____ have strokes, but strokes are more likely to be fatal in ____.

What three races have a higher risk of stroke?

The ____ of the cerebrum controls emotion and thought.

The ____ part of the cerebrum controls touch and movement.

The ____ part of the cerebrum processes sight.

In most people, speech is controlled on the ____ side of the brain near the middle of the cerebrum.

____ cranial nerves run directly from the brain to parts of the head.

The rest of the nerves join in the spinal cord and exit the brain through a large opening in the base of the skull called the:

At each vertebra in the neck and back, ____ nerves branch out.

The brain is very sensitive to changes in (three things):

If a problem is caused mainly by disorders in the heart and lungs, the ____ brain will be affected.

If a problem is mainly in the brain, only ____ of the brain is affected.

When does a headache require assessment and transport?

If more than one patient reports headache, consider:

Most common headache:

Headaches that are the second most common type:

These headaches are caused by muscle contractions in the head and neck and are attributed to stress.

Headaches that are thought to be caused by changes in the blood vessel size in the base of the brain.

Headaches that are caused by pressure that is the result of fluid accumulation in the sinus cavities.

Three serious conditions that include headache as a symptom:

An interruption of blood flow to the brain that results in the loss of brain function.

There are two main types of stroke:

An ____ stroke is due to the direct blockage of blood flow through the cerebral arteries.

A clot forms at the site of blockage

Clot forms in a remote area and then travels to the site of blockage.

In ____ stroke, a blood vessel ruptures, causing increased pressure in the brain and subsequent brain damage.

Most common type of stroke, accounting for 85% of strokes:

____ in the blood vessels is often the cause of ischemic strokes.

Disorder in which calcium and cholesterol build up, forming a plaque inside the walls of the blood vessels.

Type of stroke that accounts for 15% of strokes:

People at highest risk of ____ stroke are those who have very high blood pressure or long-term elevated blood pressure that is not treated.

An ____ is a swelling or enlargement of an artery due to weakening of the arterial wall.

A symptom of ____ stroke may be the sudden onset of a severe headache.

When a hemorrhagic stroke occurs in an otherwise healthy young person, it is likely caused by a weakness in a blood vessel called a ____ ____.

When stroke symptoms go away on their own in less than __ hours, the event is called a transient ischemic attack.

About ____-____ of patients who have a TIA will experience a stroke soon after.

Speech disorders are called:

Slurred speech is called:

Difficulty understanding others is called:

Stroke in the ____ cerebral hemisphere may cause aphasia; the inability to produce or understand speech.

____ is the inability to produce or understand speech.

When strokes occur in the ____ cerebral hemisphere, usually, patients will understand language and be able to speak, but their words may be slurred and hard to understand.

Stroke patients may be oblivious to their problem; this symptom is called:

Patients with a problem affecting the back part of the cerebrum may neglect certain parts of their ____.

What affect does hemorrhagic stroke have on blood pressure?

Three conditions that may mimic stroke:

Period following seizure that lasts between 5 and 30 minutes, characterized by labored respirations and some degree of AMS.

Seizures account for up to __% of EMS calls.

-Formally called a grand mal seizure
-Typically characterized by unconsciousness and a generalized severe twitching of all muscles
-This type of seizure results from abnormal discharges from large areas of the brain, usually involving both hemispheres.

Seizure that begins in one part of the brain and is classified as simple or complex:

-Seizure with no change in the patient’s level of consciousness
-May have numbness, weakness, dizziness, visual changes, or unusual smells and tastes
-May also cause some twitching or brief paralysis

-Seizure where the patient has an AMS and does not interact normally with his or her environment
-Results from abnormal discharges from the temporal lobe of the brain
-Other characteristics may be lip smacking, eye blinking, and isolated jerking
-Patients also may experience uncontrollable fear and perform repetitive physical behavior

This seizure is characterized by sudden loss of consciousness, chaotic muscle movement and tone, and apnea.

During a tonic-clonic seizure, a patient may exhibit bilateral muscle rigidity (____ phase), and muscle contraction and relaxation (____ phase) follows, lasting 1 to 3 minutes.

An ____ (formerly called petit mal) seizure can last for just seconds, after which the patient fully recovers with only a brief lapse of memory of the event.

Seizures lasting more than 5 minutes are likely to progress to:

Seizures that continue every few minutes without the person regaining consciousness or last longer than 30 minutes are referred to as:

Seizures can also result from sudden high fevers, particularly in children; known as ____ seizures

Once a seizure has stopped, the patient’s muscles relax, becoming almost flaccid, or floppy, and the breathing becomes labored (fast and deep).  This breathing pattern helps the body balance the ____ in the bloodstream.

In some situations, the postictal state may be characterized by ____, or weakness on one side of the body, resembling a stroke.

The most common type of neurologic emergency that you will encounter is a patient with an:

The principal difference is that a patient who has had a ____ may be alert and attempting to communicate normally, whereas a patient with  ____ almost always has an altered or decreased level of consciousness.

____ therapy (clot dissolvers) may reverse stroke symptoms.

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