Flashcards in CVA Pathophysiology Deck (16)
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1
Statistics of stroke
Costs $74 billion/year in US.
795000 strokes a year.
1/3 will die.
#4 cause of death.
25-35% recurrance of acute.
40% within 5 years, men>women.
2
s&s of stroke
weakness, sensation deficits, facial droop, visual disturbances, difficulty talking, confusion
Cerebellar stroke: loss of balance
3
stroke risk factors
Black>hispanic>white.
HTN.
High cholesterol.
Obesity.
ETOH abuse.
Cocaine use.
Cmoking.
DM.
Heart disease.
4
Types of stroke
Thrombotic: clot in brain.
Embolic: clot elsewhere travels to brain.
Hemorrhage: bleed (from aneurysm) in brain-->heels better once the blood is absorbed.
5
Thrombotic CVA
Caused by HTN and ASCHD (atherosclerotic coronary heart disease).
"stroke in progress"
6
TIA
Indicative of throbolytic disease.
Possible vasospasm.
Transient systemic arterial hypotension.
7
Thrombotic/TIA management
PREVENTION
Goal: improve circulation ASAP.
Meds: T-PA (tissue plasminogen activator) (w/in 3 hours).
anticoagulents.
antiplatelets (ASA, persantine,).
sx: thromboendarerectomy (carotid and subclavian).
8
Embolic CVA
Sign of cardiac disease.
From: heart, ICA, carotid sinus.
Branches of MCA most common affected, with poorer outcomes.
9
Embolic CVA management
PREVENTION
Anticoagulants (long term).
sx
10
Hemorrhagic CVA
Causes: HTN, ruptured saccular aneurysm, AV malformation.
Bleeding displaces midling structures.
Blood re-absorbed over 6-8 mo.
11
Hemorrhagic CVA management
HTN: prevention.
Ruptured aneurysm: sx: post op restrictions: HOB >30*, 4-6 wks limited activity, anti-seizure med (kepra).
12
CVA movement dysfunction
Decreased force production.
Abnormal synergistic movement=later on in stroke.
Altered timing.
Decreased force regulation.
Delayed responses (toe tapping).
Abnormal tone.
Associated reactions: arm curls with difficult task.
13
CVA 2* impairments
Alignment issues.
Changes in mobility.
Contracture.
Pain.
Edema.
14
Orpington Prognostic Scale
Not for acute.
Used when neurologically stable.
Optimal predictive power at 2 weeks post stroke.
Scores: 1.6-6.8.
15
OPS scores
5.2 generally require long term care
16
