CVI

Question 1

Risk factors for strokes?

Answer 1

Poorly or uncontrolled HTN
Smoking
Insulin resistance and diabetes mellitus
Polycythemia, thrombocythemia
High cholesterol or low HDL
Congestive hear disease & peripheral vascular disease
Hyperhomocysteinemia – high homocysteine level – amino acid produced when proteins are broken down
Atrial fibrillation

Question 2

What Is a Ischemic Stroke?

Answer 2

I just
Obstruction of blood flow to the brain caused by a thrombus, embolus, or hypoperfusion –decreased blood volume or heart failure

Decreased blood flow causes ischemia and can cause infarction – death of tissue

Question 3

S+S of ischemic stroke?

Answer 3

S&S – weakness, numbness, sudden confusion, loss of balance, or sudden severe headache –resolves within an hour

Question 4

People who suffer an embolic stroke usually suffer?

Answer 4

a second stroke as the emboli still exists

Question 5

Embolic stroke Vs Thrombotic Stroke

Answer 5

Embolic stroke – sudden onset – no history of claudication – may have cardiac abnormalities – comes from a embolus elsewhere in the body

Thrombotic – slow progression – history of claudication – generally no cardiac abnormalities – history of atherosclerosis

Question 6

Signs and symptoms of of ischemic strokes?

Answer 6

dependent on the site of obstruction, damage done, extent of collateral circulation that develops

Example - Carotid – dysphagia

Generally Headache, confusion, dizziness, weakness or paralysis

Question 7

Signs and symptoms of a hypo perfusion ischemic stroke?

Answer 7

Hypoperfusion ischemic stroke - Symptoms are bilateral and diffuse

Question 8

FAST?

Answer 8

1.) Face - is it drooping
2.) Arms - can you raise both
3.) Speech - is it slurred or jumbled
4.) Time - to call 9-11 right away

Question 9

What is a hypoperfusion stroke?

Answer 9

Systemic hypoperfusion caused by cardiac failure, pulmonary embolism or hemorrhage that results in inadequate blood flow to brain

-Going to pull out large sections of plaque from the carotid

Question 10

What is an Embolic stroke?

Answer 10

Fragments that break from a thrombus formed outside the brain – heart, aorta, common carotid artery – can also be from fat, air, tumour, bacteria, foreign body – anything that is denser and causes a clog

Question 11

Risk factors for an embolic stroke?

Answer 11

Clot coming from the heart and travels through to the brain - A fib

think about what can be happening in the heart – atrial fibrillation, potential for pooling of blood and then sending clot into cerebral circulation, left atrial or ventricle disease – blood flow is coming from the left ventricle, recent myocardial infarction, defects, tumours

Question 12

Where do embolic stroke obstruct?

Answer 12

Usually small brain vessels – obstructs at a bifurcation

Question 13

What is a thrombotic stroke?

Answer 13

Arterial occlusions caused by thrombi in arteries supplying brain or intracranial vessels

Question 14

Risk factors for thrombotic strokes?

Answer 14

Risk factors – increased coagulation or inadequate cerebral perfusion

Question 15

Outcome of a right sided stroke?

Answer 15

Left sided weakness or paralysis

Denial of paralysis – reduced insight into condition – “left neglect” – lack of response to stimuli on the left side

Visual – can’t see the left side

Depth perception

Recognition of body parts

Memory problems

Depression,

inappropriate behaviours,

Impulsivity

Question 16

Outcome of left sided hemisphere stork damage?

Answer 16

right sided weakness or paralysis

Problems with speech – speaking and understanding

Visual – can’t see the right side of field of vision – both eyes

Depression & cautiousness

Impaired cognitive abilities

Memory problems

Question 17

What is a migraine?

Answer 17

episodic neurologic disorder headache lasting 4-72 hours

Basically – we can have a migraine with an aura or a migraine without an aura – can be a visual, sensory, or motor aura

Question 18

Signs and symptoms of a migraine?

Answer 18

Pain, nausea and visual changes are typical of a classic form

Question 19

Cluster headache

Answer 19

Short term
one side
most painful

Question 20

Tension headache?

Answer 20

Tight band around the head and both sides

Dehydration headache that is going on

Minor headaches

Can sometimes tell what brings them on

Question 21

What are the 4 phases of a headache?

Answer 21

Premonitory phase – hours to days before onset of a headache – tiredness, irritability, inability to concentrate, and stiff neck

Migraine aura –may last 1 hour. Symptoms include visual (flashes of light), sensory (tingling on one side of body), or motor (inability to speak clearly)– only 1/3 of people report having an aura

Headache phase – throbbing and spreading to the entire head – accompanied by nausea, vomiting, fatigue, & dizziness – this is the stage that may last 4-72 hours

Recovery phase – irritability, fatigue, & depression – lasts hours to days

Question 22

What are individuals who suffer from migraines are at a higher risk of?

Answer 22

Individuals who suffer from migraines are at higher risk of epilepsy, depression, anxiety, cardiovascular disease, & stroke

Question 23

What is meningitis?

Answer 23

Inflammation of the meninges of the brain or spinal cord

Question 24

What is a TIA - transient ischemic attacks

Answer 24

Focal cerebral ischemia
S&S – weakness, numbness, sudden confusion, loss of balance, or sudden severe headache –resolves within an hour
If MRI scan reveals infarction – can be sign of upcoming stroke – within 90 days

Question 25

What is a hypo fusion stroke?

Answer 25

A kind of ischemic stroke

Systemic hypoperfusion caused by cardiac failure, pulmonary embolism or hemorrhage that results in inadequate blood flow to brain
Occurs if there is carotid artery occlusion

Question 26

What Is an embolic stroke?

Answer 26

Fragments that break from a thrombus formed outside the brain – heart, aorta, common carotid artery – can also be from fat, air, tumour, ba

Usually small brain vessels – obstructs at a bifurcation

Question 27

Risk factors for embolic stroke? What do they usually suffer?

Answer 27

Risk factors – think about what can be happening in the heart – atrial fibrillation, potential for pooling of blood and then sending clot into cerebral circulation, left atrial or ventricle disease – blood flow is coming from the left ventricle, recent myocardial infarction, defects, tumours

-People who suffer and embolic stroke usually suffer a second stroke as the emboli still exists

Question 28

What is a Hemorrhagic stroke?

Answer 28

Intracranial aneurysms
Arteriosclerosis, congenital abnormality, cocaine use, trauma, inflammation, vascular sheer wall stress
Most located at bifurcation in or near the circle of Willis, vertebrobasilar arteries, or carotid arteries – due to higher sheer stress & turbulence
Often ‘berry or saccular in shape or can have fusiform or giant aneurysms
Rupture into the subarachnoid space – produces localized changes & irritation of arteries and nerves
Bleeding stops when a fibrin-platelet plug forms – reabsorption through arachnoid villi within 3 weeks

Question 29

Signs and symptoms for a Hemorrhagic stroke?

Answer 29

often asymptomatic
dizziness, or headache – cranial nerve compression
Cranial nerves 3, 4, 5, & 6 most often affected
If cranial nerves are affected – stroke on left side shows left sided deficits
Optic chiasma