Pathophys Test 3

  1. THROMBOTIC Stroke (p.2-3)
    • More common than embolic
    • Occur in small and large arteries
    • Result from obstruction of blood flow in an 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 becomes lodge in cerebral circulation
    • Can lodge in small vessels
    • At risk – patient with plaque formation, a-fib, valvular heart disease, coronary heart disease, or cardiomyopathy
  3. HEMORRHAGIC Strokes (p.2-3)
    • 20% of strokes
    • Occurs when blood vessel supplying brain ruptures
    • As clot expands, pressure placed on brain tissue and surrounding rim of clot becomes ischemic
  4. SUBFLOW Strokes (p.2-3)
    • Too little blood flow to brain causes:
    • o Blood clot (thrombus) originating in brain
    • o “Traveling” blood clot (embolus) from outside the brain
    • Either way, thrombus or embolus in brain impedes/stops blood flow from involved vessel
    • Result = cerebral infarction
  5. When would tPA be contraindicated in patient with ischemic stroke? (p.61)
    • Symptoms are minor or are rapidly improving
    • Seizure at onset of stroke
    • Another stroke or previous head trauma within past 3 months
    • Major surgery within 14 days
    • Known history of ICH
    • Sustained SBP > 185 mmHg
    • Sustained DBP > 100 mmHg
    • Aggressive treatment required to lower BP
    • Symptoms suggestive of SAH
    • GI or urinary hemorrhage within 21 days
    • Arterial puncture at noncompressible site within 7 days
    • Received Heparin within 48 hours and has elevated PTT
    • PT > 15 seconds or INR > 1.7
    • Platelet count < 100,000 uL
    • Serum glucose <50 or >400 mg/dL
  6. What is usual cause of subarachnoid hemorrhage? (p.6)
    • Rupture of cerebral aneurysm
    • When aneurysm ruptures, blood enters subarachnoid space ( ICP) encircling the brain (--> blood can act as irritant to brain generating vasospasm)
  7. How would patient typically describe HA associated with SAH?
    • “Worst headache of my life”
    • Sudden, intense, of un-distinct location or quality, different than previous HA
    • HA can be followed by transient LOC
Card Set
Pathophys Test 3
Neurodynamics 10-12