neuro pt 1 Flashcards
(35 cards)
types of brain insults
ischemia insults, acute insults, increased ICP, degenerative disorders
global ischemia
when blood flow cant meet metabolic demands, ischemia of the entire brain
focal ischemia
ischemia to one focal or specific portion of the brain
categories of strokes
ischemic or hemmorrhagic
categories of ischemic strokes
thrombolytic (disease), embolic (clots), or hypoxic (events)
thrombolytic strokes
most common, local action, build up of plaque, clot stays in one place, atherosclerosis
embolic strokes
clot originates somewhere in the body and travels to the brain, can be secondary to thrombotic
causes of ischemic strokes
atherosclerotic/cerebrovascular disease
cardiogenic source- A fib
artherolsclerosis
large vessel disease
build up of fats, cholesterol, and other substances in artery
20% of ischemic strokes
middle cerebral artery occlusion-most commone
anterior cerebral artery occlusion- least common
cerebral “small vessel disease”
-25% of ischemic strokes
-small and deep
-closely linked to hypertension
-leading cause of loss of function, disability, age-related congitive decline related to dementia, strokes, motor movement issues
clot embolism
embolism breaks off at or near side of a thrombus and travels to brain
TIA
short lived form of brain ischemia
-symptoms caused by cellular hypoxia without cellullar death
-warning sign
-15% of people expereince a full stroke within 3 months of TIA
cardiogenic source of stroke
20% of ischemic strokes
a fib
MI
endocarditis
unusual/unknown causes
35% of strokes
vasospasm after subarachnoid hemmorrhage
-cerebral vasoconstriction syndromes
-air or fat embolisms
-amniotic fluid following childbirth
tumors
ischemic penumbra
zone of reversible ischemia around core of irreversible infarction
salvageable in first few hours after ischemic stroke infarct
hemorrhagic strokes
burst blood vessel may allow blood to seep into and damage brain tissues unti clotting shuts off the leak
process of brain hemorrhage
- rupture pf blood vessel
- bleeding goes into brain
- creates a focal hematoma that may get larger
- brain swells
- brain matter gets compressed
- coma/death
symptoms of hemorrhagic strokes
-person feels a thunderclap headache
-contralateral hemiplegia
-leads to spasticity
-loss consciousness
-increased ICP
-coma/posturing/death
causes & risk factors for hemorrhagic strokes
-unctrolled HTN
-anticoagulation therapy
-cerebral aneurysms
-arteriovenous malformations
-head trauma (open or closed)
-age (over 40)
-morbid obesity
-smoking/excessive alcohol
-drugs that spike BP (cocaine)
-more common among women
-post-orgasm hemorrhage
types of hemorrhagic strokes
intracerebral hemorrhage
subarachnoid hemorrhage
intracerebral hemorrhage- ICH
-from deep penetrating vessels
-causes injury to brain tissue by disrupting connecting pathways and causing localized pressure injury
-fast bleeding withint brain tissue itself
-life threatening
-most commonly caused by uncontrolled hypotension
subarachnoid hemorrhage-SAH
intracranial bleeding into arachnoid and pia mater membranes on surface of brain tissue
-ruptured vessel-slow
-thunderclap headache
-bleeding into subarachnoid space
-slower process than ICH
-usually related to aneurysm
-often found in anterior circulation near circle of willis
ICH process
- rupture vessel cause bleeding-hematoma
- brain tissue injury distal to the bleed from lack of O2 and ATP
- Spasm of adjacent vessels
- increases ICP from the hematoma
- as the brain swells it gets compressed by the skull
- loss of consciousness
- coma
- brain herniation
- left untreated-death
brainstem stroke
very dangerous CVA
-controls vital functions
-HR/function
-lungs-rate/function
-swallowing
-eye movement
-facial movement & sensation
-hearing
