15 Questions
What is the term commonly used to refer to the underperfused, potentially threatened brain parenchyma in ischemic stroke?
Penumbra
Which of the following does modern neuroimaging NOT provide information on in acute ischemic stroke?
Current heart rate
What is crucial for making the most appropriate management decisions in acute ischemic stroke?
Tissue damage assessment
What influences the choice between using CT and/or MRI for imaging a stroke patient at presentation?
Type of stroke (hemorrhagic vs. ischemic)
Which parameter is NOT listed as one of the key parameters in ischemic stroke when using CT and MRI imaging?
Assessment of cholesterol levels
What is the name given to the early infarct area that is considered irreversible tissue damage in acute ischemic stroke?
"Core infarct"
Which term does NOT accurately describe the information provided by modern neuroimaging in acute ischemic stroke?
"Hemorrhagic presence detection"
What does imaging the acute ischemic stroke patient with CT and MRI NOT provide valuable information on?
"Patient's age"
Which statement accurately describes the role of modern CT and MRI in imaging acute ischemic stroke?
Modern CT and MRI are powerful tools to assess hemorrhage presence and evaluate brain tissue at risk.
Which type of Salter-Harris fracture has the best prognosis?
Type I
In which Salter-Harris fracture type does the fracture pass directly through the metaphysis, growth plate, and down through the epiphysis?
Type IV
Which Salter-Harris fracture type interrupts the proliferative and reserve zones, leading to a poorer prognosis?
Type III
What is the mnemonic that can be used to remember the Salter-Harris classification types?
SALTR
Which Salter-Harris fracture type is considered most uncommon?
Type V
What percentage of Salter-Harris fractures are type II, making it the most common type?
~75%
Study Notes
Acute Ischemic Stroke
- Acute ischemic stroke is common and often treatable, requiring reliable information on the brain's physiologic state to ensure successful treatment.
- Modern neuroimaging provides information on hemorrhage presence, site of arterial occlusion, early infarct "core" size, and underperfused brain parenchyma ("penumbra").
Imaging Stroke Physiology
- CT and MRI are powerful tools for evaluating the brain's physiologic state during and after ischemic insults.
- The choice of CT and/or MRI depends on the patient's clinical state and therapeutic options.
Key Parameters in Ischemic Stroke
- Presence of hemorrhage
- Site of arterial occlusion
- Size of early infarct "core"
- Size of underperfused brain parenchyma ("penumbra")
Imaging Options
- CT and MRI provide valuable diagnostic and prognostic information on ischemic stroke.
- These technologies inform on presence of hemorrhage, vessel occlusion, irreversible injury, and tissue at risk.
Salter-Harris Classification
- Proposed by Salter and Harris in 1963, it remains the most widely used system for describing physeal fractures.
- The mnemonic "SALTR" helps remember the types:
- Type I: Slipped (5-7%), fracture plane passes through the growth plate, not involving bone.
- Type II: Above (75%), fracture passes across the growth plate and up through the metaphysis.
- Type III: Lower (7-10%), fracture plane passes along the growth plate and down through the epiphysis.
- Type IV: Through or transverse (10%), fracture plane passes directly through the metaphysis, growth plate, and down through the epiphysis.
- Type V: Ruined or rammed (uncommon), fracture plane passes directly through the metaphysis, growth plate, and down through the epiphysis.
Learn about the importance of modern neuroimaging in determining the state of the brain in patients with acute ischemic stroke. Topics covered include the presence of hemorrhage, site of arterial occlusion, infarct size, and underperfused brain parenchyma.
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