Cerebrovascular Disease & Stroke Flashcards

What percentage of all strokes are classified as ischemic strokes?

Answer: Approximately 87%

Ischemic strokes account for approximately 87% of all strokes, making them by far the most common type.

Which small penetrating arteries are most commonly involved in lacunar infarcts affecting the basal ganglia and internal capsule?

Answer: Lenticulostriate arteries

Lenticulostriate arteries are small penetrating branches of the MCA that supply the basal ganglia and internal capsule, making them the primary vessels involved in lacunar infarcts at these sites.

A patient presents with sudden right-sided face and arm weakness, expressive aphasia, and left gaze preference. Which arterial territory is most likely occluded?

Answer: Left middle cerebral artery

Left MCA territory strokes cause contralateral (right-sided) hemiparesis, Broca's or global aphasia, and ipsilateral gaze preference (eyes deviate toward the lesion side).

What is the approved time window for IV alteplase (tPA) administration in eligible acute ischemic stroke patients per current guidelines?

Answer: Within 3 to 4.5 hours of symptom onset

IV alteplase is approved for use within 3 to 4.5 hours of symptom onset in eligible patients, with the extended window supported by the ECASS-3 trial.

Wallenberg (lateral medullary) syndrome, caused by PICA occlusion, classically presents with which combination of findings?

Answer: Ipsilateral facial pain/temperature loss, contralateral body pain/temperature loss, vertigo, and dysphagia

PICA occlusion causes lateral medullary syndrome with ipsilateral facial sensory loss, contralateral body hemianesthesia (crossed pattern), vertigo, dysphagia, hoarseness, Horner syndrome, and ipsilateral limb ataxia.

Which of the following is the single most important modifiable risk factor for ischemic stroke?

Answer: Hypertension

Hypertension is the most prevalent and impactful modifiable risk factor for both ischemic and hemorrhagic stroke, contributing to endothelial damage, atherosclerosis, and small vessel disease.

The NIH Stroke Scale (NIHSS) is used in acute stroke care primarily to:

Answer: Quantify neurological deficit severity and guide treatment decisions

The NIHSS is an 11-item validated scale (scores 0–42) used to objectively quantify neurological deficit severity, guide thrombolysis eligibility, and monitor clinical progression.