Neuro Stroke Flashcards
(38 cards)
where do the carotid arteries circulate blood in the brain
anterior circulation
where do the vertebral arteries circulate blood in the brain
posterior circulation
how long does loss of blood supply result in cellular brain death
5 mins
what are some factors that affect blood flow
Systemic B/P; CO; viscosity of blood
why are older adults able to retain more brain function after loss of blood flow then younger adults
collateral circulation happens over time making new paths - so older adults have more routs for blood flow then younger adults
what is a thrombotic stroke
grew in one area and stayed - blocked blood flow
what is a embolic stroke
came from another area in the body and blocked blood flow
whats the difference between Intracerebral and Subarachnoid Hemorrhage
Intracerebral is more inside the brain and hard to get to, Subarachnoid on the outer of the brain and easier to get to and drain
what is the included in the initial evaluation for a stroke
Head CT Scan no contrast needed, PT/INR & PTT, 12 Lead ECG (to know if that caused it like afib), B/P, Neuro Evaluation, Last KNOWN Normal (LKN) – last time someone can say they weren’t acting normal
what is a transient ischemic attack
brief episode where one of the vessels that supply blood to the brain gets blocked it lasts less then 1 hour and return to baseline within 24 hours
what are some measures to prevent development of a thrombus or embolus in patients at risk for stroke
Antiplatelet drugs are used in patients who have had a TIArelated to atherosclerosis, Aspirin is most frequently used as an antiplatelet agent
what is a surgical intervention used for transient ischemic attacks
Carotid endarterectomy or Transluminal angioplasty with Stenting
what are the interventions for Carotid endarterectomy
Monitor for swelling at incision site and prevent actions that would increase ICP
Frequent Neuro Checks
what are some normal findings after Carotid endarterectomy
Neck soreness; low grade temp; difficulty to swallow (dysphagia)
what are some modifiable risk factors for stroke
hypertension, Heart disease, DM, Serum cholesterol, Smoking, Obesity, Sleep apnea, Metabolic syndrome, Lack of physical exercise, Poor diet, Drug and alcohol abuse, Estrogen replacement therapy & high dose estrogen containing Birth Control
what are some non modifiable risk factors for stroke
Age (Stroke risk doubles each decade after 55), Gender (More common in men; more women die), (Ethnicity/race
Higher incidence in African Americans bc BP), Heredity/family history
what are some diagnostic for CVA
CT w/o contrast (indicate size and location and shows difference between ischemic and hemorrhagic stroke), MRI, ECHO, MRA
when is medication recommend to control BP
greater then 220/ greater then 120
does HTN and DM put you more at risk for thrombotic or embolic stroke
thrombotic
does a fib and cardiac valve abnormalities put you more at risk for thrombotic or embolic stroke
emobolic
what does the Recombinant tissue plasminogen activator (tPA) med do
Used to reestablish blood flow through a blocked artery toprevent cell death– can be targeted, Must be administered within 3 to 4 ½ hours of onset ofclinical signs of ischemic stroke a head ct is done first to rule out hemorrhage
After the patient has stabilized and to prevent further clotformation, patients with strokes caused by thrombi andemboli may be treated with what
plateletinhibitors and/or anticoagulants, aspirin is started in the first 24-48 hours, statins
what are the inclusion criteria of intraarterial tPA
ober 18 yrs old, diagnosis of stroke with measurable deficit, time of onset less then 3 hours before tx will begin
what is the exclusion criteria for intraarterial tPA
evidence of ICH on CT, hx of ICH or AVM, suspected SAH with normal CT, active internal bleeding, platelets less then 100,000, heaprin within 48 hours with an elevated PTT, current use of oral anticoagulant with PT over 15 secs,
