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Geriatric Dentistry
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Lectures
Stroke Syndromes
Author
: David Thaler, M.D.,Ph.D.
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Stroke Syndromes
Brain Attack!
Impact of acute ischemic stroke
Estimated prevalence of stroke by age and sex
Modifiable and non-modifiable risk factors
Symptoms of stroke
Stroke Syndrome: Slide 7
Branches of the middle cerebral artery
Vascular territories - Coronal section
Vascular territories - Medulla
Stroke Subtypes
Four types of intracranial hemorrhage
Intracerebral hemorrhage: Causes
Hypertensive ICH: Locations
Intracerebral hemorrhage: Symptoms/Signs
Lobar hemorrhage
Putamenal hemorrhage
Intracerebral hemorrhage: Treatment
Aneurysms
Cerebral aneurysms: Symptoms
Stroke Syndrome: Slide 21
Subarachnoid hemorrhage: Symptoms
Subarachnoid hemorrhage: Signs
Subarachnoid hemorrhage: Diagnosis
Subarachnoid hemorrhage
Subarachnoid hemorrhage
Hunt and Hess Classification of subarachnoid hemorrhage
Subarachnoid hemorrhage: Major concerns
Subarachnoid hemorrhage: Management
Arteriovenous malformation (AVM)
Arteriovenous malformation (AVM): Symptoms
Arteriovenous malformation (AVM)
Arteriovenous malformation (AVM): Treatment
Stroke Subtypes
Stroke: Definition
Stroke defined by pace
What is the underlying mechanism?
Common mechanisms of cerebral ischemia
Etiology of ischemic stroke
Small vessel disease
Stroke Syndrome: Slide 42
Major lacunar syndromes (C.Miller Fisher)
Lacunar stroke (0.2-15mm3)
Other causes of cerebral ischemia
Ms I.C.
Carotid dissection
Mimics of cerebral ischemia
Risk for stroke after transient ischemic attack (TIA)
Unstable angina of the brain
Transcranial ultrasound
Baseline: Conventional T2 vs. Diffusion
24 Hours: Conventional T2 vs. Diffusion
Diffusion/Perfusion mismatch
Diffusion/Perfusion match
Conventional angiography
Carotid angiogramInternal carotid artery stenosis
Carotid artery disease
Carotid artery stenosis: Treatment
Proximal aortic atherosclerosis
Cardiac conditions associated with cerebral embolism
Cardiac conditions associated with cerebral embolism
Investigations for hypercoagulable states
Progression of ischemic stroke
Strategies for acute stroke treatment
The Plumbing Approach
National Institute of Neurological Diseases and Stroke (NINDS) t-PA trial
NINDS t-PA Trial
Symptomatic hemorrhages
NINDS t-PA Trial
Neuroprotection
Cerebral response to declining blood flow
Stroke Syndrome: Slide 73
Neuroprotectant mechanisms and some tested compounds
Timing, timing, timing
Immediate management of patients with suspected stroke
Immediate management of patient with suspected stroke
Short-term complications
Prevention of DVT
The Magic Hour
Time: Traditional vs. Emerging Views
Brain Attack!
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