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Stroke
Overview
27
Anatomy
Kindergarten
11/29/2013

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Cards

Term
build up of lipids and inflammatory cells
Definition
carotid atherosclerosis
Term
hypertrophy of arterial smooth muscle cells
Definition
result= plaque formation
Term
arterial stress
Definition
causes plaque to rupture
Term
platelet aggregation
Definition
result= clot formation
Term
cardiogenic embolism
Definition
static blood in atria or ventricles --> clot formation
Term
blood flow is temporarily blocked; resolution is spontaneous
Definition
transient ischemic attack
Term
80% cleared within 10 minutes from circulating plasma
Definition
Alteplase
Term
Alteplase (Activase)
Definition
FDA approved for the treatment of acute ischemic stroke
Term
Avoid for the first 24 hours after r-tPA txt of acute ischemic stroke
Definition
heparin; warfarin; aspirin, clopidogrel
Term
Hyperglycemia supportive care in an acute ischemic stroke
Definition
monitor for the first 48 hrs; goal: 100-180 mg/dL; persistent (>200) during first 24 hrs associated with increased risk of hemorrhagic transformation, poor neurological outcomes and/or worsening thereof
Term
supportive care acute ischemic stroke: blood pressure control
Definition
Labetalol (Trandate)- first line therapy; Nicardipine (Cardene)-second line therapy
Term
symptoms: acute neurologic deterioration, new headache, acute hypertension, nausea/vomiting
Definition
suspected conversion from ischemic stroke to hemorrhagic
Term
management of hemorrhagic stroke
Definition
airway; blood pressure; cerebral vasospasm after subarachnoid hemorrhage; elevated intracranial pressure; fluid and electrolyte homeostasis; seizure prevention/treatment
Term
cerebral vasospasm
Definition
sustained narrowing of large cerebral vessels at the base of the brain leading to delayed ischemic neurologic deficits
Term
a primary concern with subarachnoid hemorrhage
Definition
cerebral vasospasm
Term
highly lipophilic calcium channel blocker (used for cerebral vasospasm)
Definition
Nimodipine (nimotop)
Term
Post Stroke Care
Definition
VTE Prophylaxis
Term
VTE Prophylaxis in ischemic stroke
Definition
low dose SQ heparin or LMWH
Term
VTE prophylaxis for intracerebral hemorrhage
Definition
compression stockings; low dose SQ heparin or LMWH
Term
VTE prophylaxis for subarachnoid hemorrhage
Definition
no formal guidelines
Term
window for r-tPA based on eligibility
Definition
3 hours
Term
secondary stroke prevention
Definition
antiplatelets; anticoagulants; statins; lifestyle modification
Term
Acute Ischemic Stroke: non-pharmacologic therapy: Severe cerebral edema from a large infarction
Definition
craniectomy-- brain pressure release; decompression- limited to neurosurgical availability
Term
Acute Ischemic Stroke: non-pharmacologic therapy: Intracerebral hemorrhage
Definition
surgery benefits: not well documented and controversial; extraventricular drain (EVD) and intracranial pressure monitoring
Term
Acute Ischemic Stroke: non-pharmacologic therapy: intracranial aneurysm or an arteriovenous malformation (AVM)
Definition
clip or ablate offending vascular abnormalities
Term
secondary prevention of acute ischemic stroke
Definition
Carotid Endarterectomy (CEA)--- ulcerated carotid artery, stenotic carotid artery; Carotid stenting--- FDA investigational
Term
Stroke Complications
Definition
paralysis, cognitive deficits, language deficits, emotional deficits, pain
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