Neurological Emergencies & Stroke Management Flashcards

The Cincinnati Prehospital Stroke Scale (CPSS) assesses which three components?

Answer: Facial droop, arm drift, and speech abnormality

The CPSS evaluates facial droop, arm drift, and speech abnormality to rapidly identify stroke in the prehospital setting.

What is the generally accepted time window from symptom onset for IV tPA administration in acute ischemic stroke?

Answer: Within 3–4.5 hours

IV tPA (alteplase) is approved within 3 hours of symptom onset, with select guidelines extending to 4.5 hours for eligible patients.

A patient with a GCS of 3 has which combination of component scores?

Answer: Eye 1, Verbal 1, Motor 1

A GCS of 3 is the minimum possible score, representing no eye opening (1), no verbal response (1), and no motor response (1).

First-line pharmacological treatment for status epilepticus in the prehospital setting is:

Answer: Benzodiazepines (lorazepam, diazepam, or midazolam)

Benzodiazepines are first-line for status epilepticus due to rapid onset and GABA-mediated seizure termination.

Cushing's triad, indicating severely elevated intracranial pressure, includes:

Answer: Hypertension, bradycardia, and irregular respirations

Cushing's triad is hypertension with widened pulse pressure, bradycardia, and irregular respirations, signaling imminent brain herniation.

A patient presents with sudden unilateral weakness and slurred speech. Blood glucose is 45 mg/dL. Your first intervention should be:

Answer: Administer dextrose or glucagon to correct hypoglycemia

Hypoglycemia mimics stroke; correcting blood glucose must occur before activating stroke protocol, as the symptoms may fully resolve.

Which finding is most characteristic of uncal herniation syndrome in a head-injured patient?

Answer: Unilateral fixed and dilated pupil with contralateral hemiplegia

Uncal herniation compresses cranial nerve III ipsilaterally, causing a fixed dilated pupil, with contralateral motor deficits from corticospinal tract compression.