Stokes - Chapter 57 Flashcards
(28 cards)
FAST for warning signs of stroke. (what does it stand for)
F - Face drooping
A- Arm weakness
S - Speech difficulties
T - Time
What are the non modifiable risk factors for stroke?
- age
- gender
- ethnicity or race
- family hx or hereditary
What do you know about strokes and African Americans?
- higher rate incidence of strokes than white
- 3x more likely to have hemorrhagic stroke
- experience increased rates of hypertension, diabetes mellitus and sickle cell anemia
- Higher incidence of smoking and obesity than whites
- are twice likely to die from stroke than whites
What are the modifiable risk factors for strokes?
- 90% of strokes occur from modifiable risk factors
include:
- hypertension, heart disease, diabetes mellitus, smoking, obesity, sleep apnea, metabolic syndrome, lack of physical exercise, poor diet and drug and alcohol abuse
What does TIA stand for and what is it?
- Transient ischemic attack (TIA)
- Its a transient episode of neurologic dysfunction caused by focal brain, spinal cord or retinal ischemia BUT without acute infarction of the brain. Symptoms last less than an hour. Has possibility to turn into a stroke.
In a TIA block of the carotid system what do you expect to see?
- pts may have temp loss of vision in one eye (amaurosis fugax), transient hemiparesis, numbness or loss of sensation or sudden inability to speak.
In a TIA block of the vertebrobasilar system what do you expect to see?
tinnitus, vertigo, darkening or blurred vision, diplopia, ptosis, dysarthria, dysphagia, ataxia, unilateral or bilateral numbness or weakness
Two different types of strokes?
Ischemia and hemorrhagic
Which is a more common stroke?
Ischemia accounts for 87% of all strokes
What are the two types of ischemic strokes?
Thromobtic and embolic
Thrombotic strokes (gender/age, warning and onset and prognosis)
- occurs in men more than women
- warning can be TIA (30-50%)
- onset during or after sleep
- S/s develop slowly usually some improvement in survivors (20-25%)
Embolic strokes (gender/age, warning and onset and prognosis)
- men more than women
- warning TIA (UNCOMMON)
- onset most likely during activity
- single event s/s develop quickly, usually some improvement, recurrence often if underlying problem not treated
What are the two types of hemmorhagic strokes?
intracerebral and subarachnoid
Intracerebral (gender/age, warning and onset and prognosis)
- slightly higher in women than men
- warning Headache 25%.
- onset activity often
- progression over 24 hrs
- poor prognosis, fatality more likely with presence of coma
Subarachnoid (gender/age, warning and onset and prognosis)
- slightly higher in women
- youngest median age
- Warning HEADACHE often
- onset activity, most commonly related to head trauma
- usually single sudden event, fatality more likely with presence of coma
Anterior Cerebral stroke manifestations
- motor and/or sensory deficit (conlateral), sucking or rooting reflex, rigidity, gait problems, loss of proprioception and fine touch
Middle cerebral stroke maifestations
Dominant side: aphasia, motor and sensory deficit, hemianopsia (decreased vision or blindness on one side)
- non dominant side: neglect, motor and sensory deficit, hemianopsia
Posterior cerebral
- hemianopsia (decreased vision or blindness on one side), visual hallucination, spontaneous pain, motor deficit
Vertebral
- cranial nerve deficits, diplopia, dizziness, nausea, vomiting, dysarthria, dysphagia and/or coma
Right-brain damage (stroke on right side of the brain)
- paralyzed left side: hemiplegia
- left side neglect
- spiatal-perceptual deficits
- tends to deny or minimize problems
- rapid performance, short attention span
- impulsive, safety problems
- impaired judgement
- impaired time concepts
Left-brain damage (stroke on the left side of the brain)
- paralyzed right side (hemiplegia)
- impaired speech/language apahasias
- impaired right/let discrimination
- slow performance, cuatious
- aware of deficits: depression, anxiety
- impaired comprehension related to language, math
What are the 3 different types of aphasia?
Broca’s, wernicke’s, global and ‘other’
Broca’s characteristics
- type of nonfluent aphasia
- damage to frontal lobe of the brain
- frequenctly speak in short phrases t hat make sense but are produced with great effort
- Often omit small words such as is, and and the
- may say walk dog, meaning “i will take the dog for a walk” or “book book two table for “there are two books on the table
- Typically understand speech of others fairly well
- often aware of their difficulties and can become easily frustrated
Wernickes aphasia characteristics
- type of fluent aphasia
- damage occurs in left temporal lobe , although it can result from damage to the right lobe
- May speak in long sentences that have no meaning, add unnecessary words, and even create made-up words
- may say “you know that smoodle pinkered and that i want to get him round and take care of him like you want before”
- Often difficult to follow what person is trying to say
- usually have great difficulty understanding speech
often unaware of their mistakes
