cva artery

GCS:http://en.wikipedia.org/wiki/Glasgow_Coma_Scale

NE: http://medinfo.ufl.edu/other/opeta/neuro/NE_main.html
http://www.stroke.org.tw/guideline/guideline_index.asp

ml=widht1(cm) * width2(cm) * cut number / 2
mca=butterfly wings lateral, aca=mercedes anterior(supraventricle more), pca=mercedes 2 legs

When blood pressure control is necessary, the use of vasodilators such as nitroprusside or nitroglycerin should be avoided because of their propensity to increase cerebral blood volume and therefore intracranial pressure. Labetalol is preferred.
Nimodipine — The calcium channel blocker nimodipine was initially used in patients with SAH to prevent vasospasm. (See "Prevention of vasospasm" below). However, despite the vasodilatory effects of nimodipine on cerebral vessels, there is no convincing evidence that nimodipine affects the incidence of either angiographic or symptomatic vasospasm.

Nimodipine is marketed as a cerebral selective drug

Artery involved	Syndrome	Pathophysiology
Anterior cerebral artery	Motor and/or sensory deficit (foot >> face, arm) Grasp, sucking reflexes Abulia, paratonic rigidity, gait apraxia	Embolic > atherothrombotic
Middle cerebral artery	Dominant hemisphere: aphasia, motor and sensory deficit (face, arm >leg >foot), may be complete hemiplegia if internal capsule involved, homonymous hemianopia. Non-dominant hemisphere: neglect, anosognosia, motor and sensory deficit (face, arm > leg>foot), homonymous hemianopia.	Embolic > atherothrombotic
Posterior cerebral artery	Homonymous hemianopia; alexia without agraphia (dominant hemisphere); visual hallucinations, visual perseverations (calcarine cortex); sensory loss, choreoathetosis, spontaneous pain (thalamus); III nerve palsy, paresis of vertical eye movement, motor deficit (cerebral peduncle, midbrain).	Embolic > atherothrombotic
Penetrating vessels	Pure motor hemiparesis (classic lacunar syndromes) Pure sensory deficit Pure sensory-motor deficit Hemiparesis, homolateral ataxia Dysarthria/clumsy hand	Small artery (lacunar) infarct
Vertebrobasilar	Cranial nerve palsies Crossed sensory deficits Diplopia, dizziness, nausea, vomiting, dysarthria, dysphagia, hiccup Limp and gait ataxia Motory deficit Coma Bilateral signs suggest basilar artery disease.	Embolic = atherothrombotic
Internal carotid artery	Progressive or stuttering onset of MCA syndrome, occasionally ACA syndrome as well if insufficient collateral flow.	Atherothrombotic > embolic