Ashley Shared "PN 224 Week 11" - 6 Picmonics
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PN 224 Week 11
- Warning Signs
- Transient Ischemic Attack (TIA)
- Reversible Ischemic Neurologic Deficit (RIND)
- Types
- Ischemic
- Thrombotic
- Atherosclerosis
- Embolic
- Atrial Fibrillation
- Hemorrhagic
- Severe Hypertension
- Opposite Side Weakness (Hemiplegia)
- Poor Proprioception
- Disoriented to Person, Place, Time
- Can't Recognize Faces (Prosopagnosia)
- Loss of Judgement and Awareness
- Impulsiveness
- Personality Changes
- Tonal Hearing Loss
- Opposite Side Weakness (Hemiplegia)
- Side to Side Discrimination
- Aphasia
- Agraphia
- Slow Performance
- Aware of Deficits
- Anxiety
- Depression
- 1) Non-contrast CT
- A) If hemorrhagic:
- Keep BP below 160/105
- Nitroprusside
- Reverse anticoagulation
- Consult neurosurgery
- NIH Stroke Scale
- Supplemental O2
- 2) Ischemic stroke/TIA
- Keep below 220 over 120
- Pressors MAP under 60 or SBP under 90
- Decide if tPA indicated
- IF tPA contraindicated, give aspirin/clopidogrel
- Long-term treatment
- Workup/management (within days of stroke)
- 1) EKG
- If AFIB present
- Warfarin or LMWH
- 2) Echocardiogram
- Heparin-warfarin bridge if thrombus present
- 3) Carotid artery ultrasound
- If over 70 percent occluded AND symptomatic
- OR just 80 percent occlusion
- Carotid endarterectomy
- Aspirin for everyone (long term)
- Statin (everyone)
- Labetalol, nicardipine
- <3 hrs tx. is thrombolytics
- tPA (tissue plasminogen)
- > 3hrs tx. anti-platelets
- Aspirin + dipyridamole
- Clopidogrel (Plavix)
- Basal ganglia
- basal ganglia
- conjugate gaze palsy
- homonymous hemianopia
- Cerebellar
- cerebellar
- ataxia
- occipital headache
- nystagmus
- Thalamic
- thalamus
- upgaze palsy
- miotic pupils
- eyes deviate Towards hemiparesis
- Pons
- pons
- pinpoint pupils
- coma
- paralysis
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