4] Background And Manage Of CVA Flashcards by Keren Poulose

What is the stroke risk test?

Face
Arm (decreased range)
Slurred speech
Time (window is closing)

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What is an ischemic stroke?

A clot blocks or impairs blood flow

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What is an hemorrhagic stroke?

The blood vessel ruptures causing a blood leak in the brain

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Majority of strokes are what kind?

Ischemic

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WHat is a TIA?

Not a stroke but has similar Sx that resolve within 24 hours

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Accounts for 87% of strokes

Ischemic

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What is the test for DVT and you DF them and they complain of pain?

Homan sign

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Most common type of ischemia stroke

Embolic

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Define embolic stroke

Blood clot formed at other location in the circulatory system; blockage breaks off and goes up

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Embolic stroke:

Cardiac origin most common; 80% of cardiac emboli include?

MCA

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May be paradoxical; congenital such as patent foramen ovale, DVT

Embolic stroke

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Define thrombotic stroke

It’s a blood clot that develops at clogged part of the vessel; they are higher up

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Typically related to abnormalities within the vessel wall like atherosclerosis, arthritis, dissections and external compression of the vessels

Thrombotic stroke

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Common precursor of thrombotic stroke?

HTN

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Thrombotic strokes can also be caused by?

Hematologist disorders and/or hypercholesterolemia

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With what disease are they likely to have thrombotic stroke?

A-fib

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Large vessel thrombosis in carotid and vertebral arteries can lead to severe what strokes?

Thrombotic

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Define lacunar strokes

Small vessel stroke that occurs distally; branches off a large artery

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What kind of stroke is typically associated with chronic HTN and diabetic microvascular disease?

Lacunar stroke

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What kind of pt has lacunar strokes?

Diabetic

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Size of infarct 2 mm to 3 cm in size

LACUNAR STROKE

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Account for roughly 25% of ischemic strokes

Lacunar strokes

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What are the 3 main types of stroke?

Ischemic
Hemorrhagic
TIA (transient ischemic attack)

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What are the 3 types of ischemic strokes?

Embolic
Thrombotic
Lacunar

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What are the 6 types of lacunar strokes?

``` Pure motor Pure sensory Sensorimotor Ataxia hemiparesis Dysarthria Clumsy hand syndrome ```

Ataxic hemiparesis is seen in?

Cerebellum

If a pt has right CVA and pure sensory what do they have?

Neglect

Common causes of this stroke: - hypertensive bleed - ICH in the presence of an AVM or tumor - ruptured aneurysm

Hemorrhagic

75% of hemorrhagic strokes caused by a bleeding blood vessel occur in ppl who have ?

HTN

Anterior cerebral artery (ACA) supplies?

Medial aspect of frontal and parietal lobes | And subcortical structures like basal ganglia

Middle cerebral artery (MCA) supplies?

Entire lateral aspect of cerebral hemisphere | Frontal, temporal, parietal

Posterior cerebral artery (PCA) supplies?

Occipital lobe, medial and inferior temporal lobe, upper brain stem, midbrain, thalamus

DO hemorrhagic strokes follow an artery distribution?

What signs and symptoms can differentiate between hemorrhagic and ischemic?

Vomiting, headache, impaired consciousness

Which brain scan is best to do for strokes?

CT scan

What is the most common hemorrhagic stroke?

Anterior communicating artery aneurysm

WHy would TIA be confused with lacunar strokes?

Because they follow a vascular distribution

Reversible; no infarction of cerebral tissue

TIA

How soon do ppl who have had a TIA, have it again?

Within 3 months but half of these happen within 48 hours

Work up essential to determine the cause and prevent future stroke

TIA

Ischemic infarct may convert into a ?

Hemorrhagic lesion

Thrombi can do what leading to small hemorrhages?

They can migrate, lyse and reperfuse into an ischemic area

In hemorrhagic conversion, what happened to capillaries and small blood vessels?

They get damaged and no longer maintain their integrity

Hemorrhagic conversions are more common in?

Large infarcts such as an occluded MCA

WHat does TPA stand for?

Tissue plasminogen activator

What does TPA do?

It's a powerful clot buster -- does thrombolysis

To use TPA you have to rule out what first?

Hemorrhagic stroke

``` Personality Behavior Emotions Judgement Planning Problem solving Intelligence Speaking and writing Concentration Self awareness ```

Frontal lobe

``` Interpreting language Touch sensation Pain Temperature Vision Hearing Memory Spatial perception ```

Parietal lobe

``` Wernicke's area (understanding) Memory Hearing Sequencing Organizing ```

Temporal lobe

Interprets vision | Light, color, movement

Occipital lobe

What 3 ways do strokes present the same on either side?

Opposite side weakness and sensory deficits | Memory deficits

2 presentations on Left sided stroke

Speech and language deficit | Slow, cautious behavior

2 presentations on right side stroke

Spatial perceptual deficits | Quick, impulsive behavior

Clinical signs of brain stem strokes

Changes in: breathing, movement, mvmt of eye sensation, HR, MP

Clinical signs of cerebellar strokes

``` Abnormal reflexes of head and torso Impaired coordination Ataxic gait (uncoordinated mvmt) Balance issues Dizzy Vomit ```

Thalamic pain syndrome clinical signs

Involuntary mvmt Contra hemiplegia Vertical eye mvmt weak

Thalamic pain syndrome is occlusion of?

Central territory of PCA

Medial medullary "dejerine" syndrome is an occlusion of?

Vertebral artery, medullary branch

Ipsi signs of dejerine

Paralysis with atrophy of 1/2 of tongue with deviation to paralyzed side

Contra signs of dejerine syndrome

UE and LE paralysis | Impaired tactile and proprioceptive info

Lateral medullary syndrome (Wallenbergs) is an occlusion of?

PICA or vertebral artery

Contra signs of wallenbergs syndrome

Impaired pain and thermal sense over 50% of body

What is the "locked in syndrome"

Occlusion of basilar artery

Clinical signs of basilar artery syndrome

Quad hemiparesis Bilateral cranial nerve palsy SPARED conscious and sensation Pt cant move or speak but is A xO

Lateral inferior pontine syndrome is occlusion of?

AICA

Acute stroke patients on typically on bed rest for how long?

24 to 48 hours

MAP ranges for ischemic

May run up to 130-140

MAP range for hemorrhagic

Needs to be less than 110

WHat does it mean if MAP ranges are too high for pt?

They're at risk for bleeding

Hemorrhagic strokes may present similar to?

TBI

If pt is moving in synergistic pattern do what?

Gravity minimized, spasticity testing

Reorganization is dependent on?

ENVIRONMENT

How to reduce spasticity for pts with stroke?

PROM and stretching with slow gradual mvmts. | DO NOT DO SUDDEN QUICK MVMTS

What kind of tasks should you do

Variable

4] Background And Manage Of CVA Flashcards

(75 cards)