Cerebrovascular Accidents Flashcards Preview

Neuroanatomy > Cerebrovascular Accidents > Flashcards

Flashcards in Cerebrovascular Accidents Deck (24)
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1
Q

Stroke or CVA

A
  • sudden onset of neurological symptoms due to a disruption of blood flow to a part of the brain
  • 3rd leading cause of death in USA
2
Q

Anoxia

A
  • Can cause the brain tissue death within a few minutes
3
Q

Ischemia CVA

A
  • 70% of strokes

- Thrombus or Embolus

4
Q

Thrombus

A
  • Ischemia CVA
  • Frequently caused by atherslcorosis which is plaque built up inside the vessel walls.
  • Result in hypoxic event
  • 100% occlusion = cerebral infart (Brain death)
5
Q

Embolus

A
  • Ischemia CVA
  • Blood clot from artery breaks away and sticks in the brain
  • Cell death occurs (irreversible)
  • Sudden onset
  • Clot: dissolving drugs can be successful if administered in the first 3 hours
6
Q

Hemorrhagic

A
  • CVA
  • Ruptured vessels, 20% of strokes
  • Intercerebral Hemorrhage
  • Subarachnoid Hemorrhage
  • Arteriovenous Malformations
7
Q

Inercerebral Hemorrhage

A
  • Usually hypertension, and age generated
8
Q

Subarachnoid Hemorrhage

A
  • Bleeding that fills the subarachnoid space
9
Q
  • Arteriovenous Malformations
A
  • Congenital abnormalities (arteries and veins directly connected, then swell over time until they rupture)
10
Q

TIA

A
  • Transient Ischemic Attack
  • A temporary interruption on the blood supply to part of the brain
  • Most symptoms last less than 5 min, all resolve completely within 24 hours
  • Prompt medical attention is necessary, but seldom sought
  • 36% of pt’s who have TIA’s will have CVA
11
Q

Warning signs of CVA

A

“SYMPTOMS SHOULD NEVER BE IGNORED”

  • Sudden blurred vision or decreased vision in one eye
  • Numbness or weakness in face, arm and/or leg on one side
  • Severe headache and/or dizziness
  • Difficulty speaking or understanding what is being said
  • Mental confusion
12
Q

Stoke Screening

A
  • S.T.R.O.K.E “Acronym”
    S: Ask pt to smile
    (Smile should be symmetrical)
    T: Ask the pt to TALK (repeat a simple sentence)
    (Should be repeated accurately and coherently)
    R: Ask the person to RAISE BOTH ARMS
    (Should be symmetrical unless the person has had prior orthopedic problems)
    O: Ask the pt to OPEN their mouth and stick out their tongue.
    (Tongue should be centered without deviation)
    KE: KALL EMERGENCY
    (If the pt has trouble with ANY ONE of these tasks, call emergency # immediately and describe the symptoms to the dispatcher
13
Q

CVA Risk Factors

A
  • Heart Disease
  • High Blood pressure (increases risk 4-6 times)
  • Cholesterol > 200
  • Smoking
  • History of TIA
  • Gender (Men at slightly higher risk)
  • Race (higher in African Americans)
  • Obesity
  • Heavy alcohol consumption
  • Diabetes
  • Age (65% occur in people > age 65)
  • Lack of exercise
  • Birth control pills (due to blood thickening and increased blood pressure)
14
Q

Prognosis of CVA

A
  • Fast recovery = more favorable prognosis
  • 10-15% have excellent recovery
  • 10-15% Die
  • 75-85% Return Home
15
Q

MVA Prognosis

A
  • Typically improve more than other deficits

- Communication, sensory, cognition harder to recover

16
Q

Rehab potential best evaluated ___ __________ post onset due to decrease in cerebral edema

A
  • 2 Weeks
17
Q

Most spontaneous recovery occurs within __ _______?

A
  • 3 Months

- Treatment is believed to be most beneficial during this time

18
Q

Rate of improvement slows dramatically by __ _____, typically resulting in no significant functional improvement after that time

A
  • 6-18 months

- May also be due to “learned non-use”

19
Q

Learned Non-Use

A
  • Decreasing length of stay in hospital and rehab settings have shifted treatment strategies from recovery of function to compensation
20
Q

Factors resulting in poor rehab potential

A
  • Unilateral Neglet
  • Anosognosia
  • Severe Proprioceptive / Kinesthetic deficits
  • Poor (Dependent) sitting balance
  • Global Aphasia
21
Q

Unilateral Neglet

A
  • Lack of awareness of one side of the body
  • Much slower initial recovery
  • Long term recovery is not dramatically less than without neglect
22
Q

Anosognosia

A
  • Lack of awareness of the presence or severity of ones paralysis
23
Q

Global Aphasia

A
  • CVA that affects the frontal and temporal lobes, resulting in difficulty understanding and forming words
24
Q

CVA Surgical Intervention

A
  • Place metal clip on aneurysm (at base)
  • Remove abnormal vessel
  • Evacuation of hematoma