CVA

Question 1

How many stroke per year?

Answer 1

800,000

Question 2

How many first time strokes?

Answer 2

600,000 3/4

Question 3

How many recurrent?

Answer 3

200,000 1/4

Question 4

Who is more at risk after age 85?

Answer 4

Women

Question 5

Who is more at risk under age 85?

Answer 5

Men

Question 6

What percent of strokes occur in 65 and younger?

Answer 6

30%

Question 7

What percent of stroke survivors will have a 2nd stroke within 1 yr?

Answer 7

5-15%

Question 8

What is the chance of having a 2nd stroke after 5 yrs?

Answer 8

24% women

42% men

Question 9

Approximately how many people die each yr due to stroke?

Answer 9

143,000

1/18

Question 10

Two types or stroke

Answer 10

38% hemorrhagic die in a month

8-12% ischemic die in a month

Question 11

Comorbidities raise risk of stroke

Answer 11

Advanced age
Htn
Heart disease
Diabetes

Question 12

Signs of stroke death

Answer 12

Loss of consciousness
Large lesion
Persistent Hemiplegia
Multiple neuro deficits
Past history of cva

Question 13

Stroke is the leading cause of what in the US?

Answer 13

Long term disability

Question 14

What % have ongoing hemiparesis?
Unable to walk unassisted?
Dependent in ADLs?
Aphasia?

Answer 14

50%
30%
26%
20%

Question 15

What percent have clinical depression after stroke?

Answer 15

35%

Question 16

What percent stroke patients will stay in long term facility?

Answer 16

26%

Question 17

Cerebral Thrombus

Answer 17

Formation of clot in cerebral arteries or branch - brain

Question 18

Cerebral infarction

Answer 18

Tissue death resulting from ischemia or occlusion of blood supply

Or atherothrombotic brain infarction ABI

Question 19

Cerebral emboli

Answer 19

Composed of bits of matter formed elsewhere that travels through the blood stream where it lodges in a vessel causing occlusion and infarction

Question 20

Intracerebral hemorrhage

Answer 20

Rupture of vessel bleed into brain

Question 21

Primary cerebral hemorrhage

Answer 21

Without trauma, high bp, small vessels weakened causing aneurysm

Question 22

Subarachnoid hemorrhage

Answer 22

Berry aneurysm
High bp
Non traumatic
Large blood vessels

Question 23

Arterial venous malformation AVM

Answer 23

Congenital

Tangle of arteries increases risk of aneurysm leading to stroke

Question 24

Reflexes

Answer 24

Involuntary instantaneous movement response to stimuli
Ischemic stroke they will come back
Babinski most commonly seen

Question 25

Left Side

Answer 25

``` Speech and Lang impaired Difficulty processing commands Slow cautious Aware of impairments Disorganized problem solving Difficulty initiating tasks Memory impair Difficulty with positive emotions Apraxia-difficulty planning/ sequencing mvmt Perseverate: repeat word or task ```

Question 26

Right side

Answer 26

``` Visual/perception impaired Neglect left side Difficulty with visual cues Impulsive Poor judgement Inability to self direct No awareness of defects Difficult with abstract problem solving Can't get big picture Can't perceive emotions Difficulty with neg emotions Performance fluctuates ```

Question 27

ACA - anterior cerebral artery

Answer 27

Contralateral hemiparesis more LE than UE Contralateral hemisensory loss involving LE than UE Incontinence Difficulty imitating apraxia Abulia: lack spontaneity seems mute, can't initiate(not common) Reflexes: sucking and contralateral grasp

Question 28

ACA CVA after rehab

Answer 28

``` Walk independently Use UE somewhat Struggle initiating task Delay in speaking Can't do bimanual task, piano ```

Question 29

MCA

Answer 29

Contralateral hemiparesis more UE, LE less effected Contralateral hemisensory loss in face, LE less effected Motor speech impairment: Brocas, gap btn words (Non fluent aphasia left side) Receptive speech impairment: wernickes-word salad impair audio Comprehension (dog,chair,fork) Perceptual deficit: unilateral neglect depth Limb kinetic apraxia can't plan Contralateral homonymous hemianopsia- miss half of room Loss of conjugate gaze to opposite side - both eyes may not move together Ataxia of contralateral limb: no idea what arm is doing