ASC Neurological Assessment & Monitoring 3

Question 1

Which intracranial pressure (ICP) waveform component, when elevated above the P1 amplitude, signals compromised cerebral compliance in a stroke patient?

Accepted Answer

P2 (tidal wave)

Answer

When P2 exceeds P1 amplitude, it indicates reduced intracranial compliance and impaired autoregulation, signaling early herniation risk.

Question 2

A patient with large hemispheric infarction is being monitored for malignant edema. The Stroke Coordinator should anticipate peak cerebral swelling at:

Accepted Answer

48–72 hours post-stroke

Answer

Cytotoxic edema following large ischemic stroke peaks at 48–72 hours and is the window of highest herniation risk.

Question 3

A right-handed patient presents with inability to name objects but intact repetition and comprehension. This pattern best localizes to:

Accepted Answer

Anomic aphasia, often with angular gyrus involvement

Answer

Anomic aphasia (isolated naming deficit with intact repetition and comprehension) most commonly involves the angular gyrus or temporal-parietal junction.

Question 4

When using transcranial Doppler (TCD) to monitor for vasospasm after subarachnoid hemorrhage, a mean flow velocity above which threshold in the MCA indicates severe vasospasm?

Accepted Answer

200 cm/s

Answer

MCA mean flow velocity >200 cm/s on TCD is classified as severe vasospasm and correlates with high risk of delayed cerebral ischemia.

Question 5

The Lindegaard ratio in TCD monitoring is calculated to differentiate vasospasm from hyperemia. A ratio above what value confirms vasospasm rather than systemic hyperemia?

Accepted Answer

3

Answer

A Lindegaard ratio (MCA velocity / extracranial ICA velocity) >3 indicates true vasospasm rather than hyperdynamic flow from systemic causes.

(ASC) Advanced Stroke Coordinator Certification Practice Test

(ASC) Advanced Stroke Coordinator Certification Practice Test

ASC Neurological Assessment & Monitoring 3