57 - Stroke Flashcards
2 types of stroke
ischemia: inadequate blood flow
hemorrhage: bleeding
others terms for stroke
brain attack
CVA
cerebrovascular accident
common long-tern disabilities of stroke
- hemiparesis
- inability to walk
- aphasia (no talk)
- depression
- partial/complete dependance on ADL
2 types of brain arteries
1 internal carotid/anterior circulation
2 vertebral arteries/posterior circulation
carotid supplies which part of the brain
frontal parietal temporal diencephalon (thalamus/hypothalamus) basal ganglia
vertebral arteries supply which part of the brain
middle/lower temporal occipital cerebellum brainstem part of diencephalon (thalamus/hypothalamus)
ideal range for blood flow and CO for optimal brain function
750 1k mL/min
20% CO
CO2
potent vasodilator in brain
-incr CO2 triggers an incr in CBF
CO must be reduced by ____ before CBF is reduced
1/3
increased ICP causes ___ + ___
brain compression + reduced CBF
____is responsible for 25% of strokes
atrial fibrilation
smoking nearly doubles the risk of _____ stroke
ischemic
TIA
transient ischemic attack
transient ischemic attack
episode of neurologic dysfunction
- caused by focal brain, spinal cord, or retinal ischemia
- WITHOUT acure infarction of the brain
- symtpms typically last 1 hr
s/s if carotid system is involved w TIA…
-temporary vision loss in 1 eye aka amaurosis fugax -temp hemiparesis -numb/loss of sensatn -aphasia
s/s if vertebrobasilar system is involved w TIA…
- tinnitus
- vertigo
- darkened/blurred vision
stroke vs TIA
strokes have infarction
2 types of ischemic strokes
thrombotic: injury to bld vssl + formation of bld clot
embolic: when an embolus lodges > occludes cerebral artery
60% of strokes are
thrombotic
is decr LOC a sign of ischemic stroke?
decr LOC is rare in first 24 hrs
thrombotic vs embolic s/s
embolic has a more severe onset + manifestations
common cause of embolic stroke in the young
rheumatic heart disease
most common cause of intracerebral hemorrhage
HTN
4 phases of a seizure
1 prodromal (senstn or bhvr chngs) 2 aural (sensory wrng each time seizure occurs, part of seizure) 3 ictal (1st sympt to end) 4 postictal (recovery)
generalized onset seizure
starts over wide areas of both sides of the brain
types of generalized onset seizure
tonic-clonic
tonic
clonic
atonic
tonic-clonic aka
grand mal
most common type of generalized onset seizure
tonic-clonic/grand mal
tonic-clonic/grand mal
- loses consciousness + falls
- tonic (stiffens) for 20-30 sec
- clonic (jerking) 30-40 sec
tonic-clonic/grand mal
S/S
- cyanosis
- excessv saliva
- tongue/cheek biting
- incontinence
- no memory
tonic
occurs most in sleep
- boths sides of body stiffent
- less than 20 sec
clonic
- loss of awareness then loss of muscle tone
- rhythmic jerking may or may not be symmetric
- RARE
atonic aka
drop attack
atonic/drop attack
- suddenly w pt falling to the ground
- less than 15 sec
- stays conscious
- risk of head injury
absence seizure
s/s
mostly in children
- staring spelling less than 10 sec is typical
- atypical is slight jerks in mouth or blinks
myoclonic
-rhythmic arm abductn (3 mvmt/second)
psychogenic/nonepileptic disorder
NOT a seizure
- needs an EEG to exclude seizure
- may be due to emotional trauma (abuse/military)
