NURS 5462 Vascular disease Questions and
Answers| Updated
CEREBROVASCULAR DISEASE
28% OF STOKES OCCUR IN PATIENTS <55 YEARS • 80% OF STROKES ARE
THROMBOTIC OR EMBOLIC,
Leading cause of disability and death among older adults
NEW EMERGING RISK FACTORS stroke
Patients with high levels of Lp-PLA2 twice as likely to suffer an ischemic stroke
over the next 6-8 years when compared to people with normal levels
PLAC test
available nationwide by Quest Laboratories Normals are 120-342 ng/ml for
women and 131-376 ng/ml for men
ASYMPTOMATIC CAROTID STENOSIS
Detected by a bruit, Duplex scan can identify which patients with bruits have
carotid stenosis, Stenosis >75% is associated with annual stroke risk of 2-3%
Perioperative stroke risk is 3% or less for CEA
,REVERSIBLE ISCHEMIC NEUROLOGIC DEFICIT
• RIND • EPISODE OF FOCAL CEREBRAL DYSFUNCTION LASTING >24 HOURS BUT
RESOLVES WITHIN 3 WKS. • ALSO KNOWN AS MINOR STROKE
CAROTID ARTERY DISEASE (anterior circulation)
MONOPARESIS OR • HEMIPARESIS • SENSORY LOSS OR PARESTHESIAS • SPEECH
DISTURBANCES • COGNITIVE IMPAIRMENT • LOSS OF VISION IN ONE EYE OR PART
OF AN EYE • AMAUROSIS FUGAX • HOMONYMOUS HEMIANOPSIA • LOSS OF
VISION OF NASAL ½ OF ONE EYE AND TEMPORAL ½ OF OTHER EYE
VERTEBROBASILAR ARTERY DISEASE post. circ.
• VERTIGO / DIPLOPIA / DYSPHAGIA / DYSARTHRIA • TWO OF THESE OR ONE OF
THESE PLUS • PARESIS • SENSORY LOSS OR PARESTHESIAS • ATAXIA •
HOMONYMOUS HEMIANOPSIA
LACUNAR SYNDROMES intracerebral DZ
Degenerative process called lipohyalinosis affecting vessels 200um or less in
diameter [Correlates with HTN]
Common lacunar syndromes→→• Pure Motor Hemiparesis • Lesion is in the Pons
• Hemiplegia or hemiparesis of face, arm and leg without sensory deficit,
dysphagia or hemianopsia
, LACUNAR SYNDROMES
*Pure Motor Hemiparesis • Lesion is in the Pons • Hemiplegia or hemiparesis of
face, arm and leg without sensory deficit, dysphagia or hemianopsia
*Pure Sensory Stroke:• Thalamus • Numbness of face, arm and leg on one side
without weakness or hemianopsia
*Ataxic Hemiparesis: • Pons • LE affected worse
*Dysarthria or "Clumsy Hand Syndrome"
• Dysarthria, facial weakness, clumsiness of hand with little or no weakness,
imbalance and positive Babinski on affected side
*Multi-Infarct Dementia-• Stepwise, progressive dementia
ISCHEMIC STROKE
Accounts for approximately 80%85% of strokes
• About 27% are due to cardiac emboli • About 19% are due to large vessel
disease • About 17% are due to small vessel disease, lesions at internal carotid
artery= Amaurosis fugax
CRYPTOGENIC STROKE
Ischemic stroke that does not have a clearly identifiable cause; Consider atypical
causes of stroke, such as vasculitis, coagulopathy, mitochondrial disorder
TIA
Answers| Updated
CEREBROVASCULAR DISEASE
28% OF STOKES OCCUR IN PATIENTS <55 YEARS • 80% OF STROKES ARE
THROMBOTIC OR EMBOLIC,
Leading cause of disability and death among older adults
NEW EMERGING RISK FACTORS stroke
Patients with high levels of Lp-PLA2 twice as likely to suffer an ischemic stroke
over the next 6-8 years when compared to people with normal levels
PLAC test
available nationwide by Quest Laboratories Normals are 120-342 ng/ml for
women and 131-376 ng/ml for men
ASYMPTOMATIC CAROTID STENOSIS
Detected by a bruit, Duplex scan can identify which patients with bruits have
carotid stenosis, Stenosis >75% is associated with annual stroke risk of 2-3%
Perioperative stroke risk is 3% or less for CEA
,REVERSIBLE ISCHEMIC NEUROLOGIC DEFICIT
• RIND • EPISODE OF FOCAL CEREBRAL DYSFUNCTION LASTING >24 HOURS BUT
RESOLVES WITHIN 3 WKS. • ALSO KNOWN AS MINOR STROKE
CAROTID ARTERY DISEASE (anterior circulation)
MONOPARESIS OR • HEMIPARESIS • SENSORY LOSS OR PARESTHESIAS • SPEECH
DISTURBANCES • COGNITIVE IMPAIRMENT • LOSS OF VISION IN ONE EYE OR PART
OF AN EYE • AMAUROSIS FUGAX • HOMONYMOUS HEMIANOPSIA • LOSS OF
VISION OF NASAL ½ OF ONE EYE AND TEMPORAL ½ OF OTHER EYE
VERTEBROBASILAR ARTERY DISEASE post. circ.
• VERTIGO / DIPLOPIA / DYSPHAGIA / DYSARTHRIA • TWO OF THESE OR ONE OF
THESE PLUS • PARESIS • SENSORY LOSS OR PARESTHESIAS • ATAXIA •
HOMONYMOUS HEMIANOPSIA
LACUNAR SYNDROMES intracerebral DZ
Degenerative process called lipohyalinosis affecting vessels 200um or less in
diameter [Correlates with HTN]
Common lacunar syndromes→→• Pure Motor Hemiparesis • Lesion is in the Pons
• Hemiplegia or hemiparesis of face, arm and leg without sensory deficit,
dysphagia or hemianopsia
, LACUNAR SYNDROMES
*Pure Motor Hemiparesis • Lesion is in the Pons • Hemiplegia or hemiparesis of
face, arm and leg without sensory deficit, dysphagia or hemianopsia
*Pure Sensory Stroke:• Thalamus • Numbness of face, arm and leg on one side
without weakness or hemianopsia
*Ataxic Hemiparesis: • Pons • LE affected worse
*Dysarthria or "Clumsy Hand Syndrome"
• Dysarthria, facial weakness, clumsiness of hand with little or no weakness,
imbalance and positive Babinski on affected side
*Multi-Infarct Dementia-• Stepwise, progressive dementia
ISCHEMIC STROKE
Accounts for approximately 80%85% of strokes
• About 27% are due to cardiac emboli • About 19% are due to large vessel
disease • About 17% are due to small vessel disease, lesions at internal carotid
artery= Amaurosis fugax
CRYPTOGENIC STROKE
Ischemic stroke that does not have a clearly identifiable cause; Consider atypical
causes of stroke, such as vasculitis, coagulopathy, mitochondrial disorder
TIA
