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Neuro > Cerebral Vascular Accident (CVA) > Flashcards

Cerebral Vascular Accident (CVA) Flashcards

1
Q

What type of stroke makes up 87% of all stroke cases?

A

ischemic stroke

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2
Q

definition: Clot formation via thrombus or embolism which blocks the blood going to the brain

A

ischemic stroke

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3
Q

(true/false) You cannot reverse ischemic stroke damage

A

False (you can reverse some aspects of the damage but there will be cases where there is no way to reverse the damage)

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4
Q

2/3 of ischemic strokes are caused by ___.

A

thrombus

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5
Q

definition: blood attached to the wall of the vessel

A

thrombus

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6
Q

definition: free roaming clot

A

embolus

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7
Q

How long does it take the ischemic core to die? Why?

A

Can die within minutes b/c there is only one artery supplying blood to it. (IRREVERSIBLE)

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8
Q

How long does it take for the penumbra to die? Why?

A

It may not die right away because it has multiple arteries providing blood to it. (REVERSIBLE)

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9
Q

What factors cause thrombi?

A
  • atherosclerotic process
  • inflammatory process
  • hematological process (EX: sickle cell disease, polycythemia)
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10
Q

Most emboli form in the ___.

A

heart

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11
Q

What are conditions that can cause emboli to form?

A
  • Valve pathology
  • A-fib
  • myocardial infarction (MI)
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12
Q

(true/false) DVTs cause an embolus in the heart.

A

FALSE (it will go to the R side of the heart and then travel to the lungs which will result in a PE)

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13
Q

What artery is the cause of 80% of strokes?

A

Middle cerebral artery

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14
Q

What are the divisions of the MCA?

A

superior, inferior

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15
Q

(true/false) both divisions of the MCA show similar symptoms when a stroke is occurring.

A

False

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16
Q

What structure separates the motor cortex and sensory cortex?

A

central sulcus

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17
Q

Precentral gyrus

A

Motor cortex

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18
Q

postcentral gyrus

A

Sensory cortex

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19
Q

What distribution does an MCA stroke have?

A

hand, face, trunk, tongue

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20
Q

What is the clinical presentation of a stroke in the SUPERIOR division of the MCA?

A
  • contralateral hemisensory deficit
  • contralateral hemiparesis
  • expressive aphasia (for dominant hemisphere)
  • left hemineglect (for non-dominant hemisphere)
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21
Q

(true/false) A stroke in the superior division of the MCA can show a visual deficit.

A

false

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22
Q

definition: attention to the environment is impaired on the non-dominant side

A

hemineglect

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23
Q

(true/false) The R cortex controls the L hemisphere attention space and a little attention space in the R hemisphere

A

true

24
Q

A stroke in what artery will show UE apraxia?

A

SUPERIOR division of the MCA artery

25
Q

A patient presents to the clinic with aphasia in the form of having a hard time speaking. They are still able to decently read and write but have trouble speaking. What part of the brain is involved? What branch of the MCA most likely was responsible for this presentation/damage?

A

Broca’s area, Superior division

26
Q

A patient presents to the clinic with aphasia in the form of having a hard time comprehending conversation and words. They are unable to read and write but do not have trouble saying words. What part of the brain is affected? What branch of the MCA most likely was responsible for this presentation/damage?

A

Wernickes area, Inferior division of the MCA

27
Q

Which is least common?
A. MCA Superior division CVA
B. MCA inferior division CVA

A

B. inferior division CVA

28
Q

What is the clinical presentation of a CVA in the inferior division of the MCA?

A
  • hemiparesis
  • hemisensory dysfunction
  • contralateral homonymous hemianopsia
  • receptive aphasia (dominant hemisphere)
  • profound left hemineglect (non-dominant hemisphere)
  • apraxia (dominant hemisphere)
  • affective language deficits (non-dominant hemisphere)
29
Q

definition: difficulty with skilled mvmt

A

apraxia

30
Q

What is the clinical presentation of a stroke in the Anterior cerebral artery?

A
  • motor and sensory loss in CONTRALATERAL LE
  • sometimes a loss of bladder function
  • hemineglect (non-dominant side)
  • gait apraxia
31
Q

A stroke in which artery can result in gait apraxia?

A

anterior cerebral artery

32
Q

Which of the following is uncommon with strokes?

A. anterior cerebral artery
B. posterior cerebral artery

A

A. anterior cerebral artery

33
Q

definition: unable to process visual information

A

anomia

34
Q

definition: the inability to read

A

alexia

35
Q

defintion: unable to write

A

agraphia

36
Q

What is the clinical presentation of a stroke in the Posterior Cerebral artery?

A
  • homonymous hemianopsia
  • gaze palsy (if near brainstem)
  • alexia WITHOUT agraphia
  • anomia
37
Q

definition: Infarction of small (deep) vessels that often result in longstanding HTN, and affects the thalamus, basal ganglia, and internal capsule of the basal ganglia

A

lacunar stroke

38
Q

What part of the brain is most affected by a lacunar stroke?

A

internal capsule of the basal ganglia

39
Q

definition: sudden motor or sensory symptoms that usually last LESS THAN 24 hours

A

transient ischemic attacks (TIA)

40
Q

(true/false) A person may not know they are having lacunar strokes until they accumulate

A

True

41
Q

If a patient experiences recurrent ____, they are more likely to have a stroke.

A

Transient ischemic attacks (TIA)

42
Q

What type of stroke has problems in regulation BP?

A

hypovolemic strokes

43
Q

Where is the watershed area that is most vulnerable for Hypovolemic strokes?

A

In between anterior cerebral circulation and middle cerebral circulation because it receives blood flow from both

44
Q

What is the distribution of hypovolemic strokes?

A
  • arm/shoulder weakness
  • thigh weakness
45
Q

What kind of stroke has an abrupt onset?

A

hemorrhagic strokes

46
Q

(true/false) For intracerebral hemorrhagic strokes, symptoms are always corresponding to a vessel.

A

False (there are cases were symptoms do not correspond to a single vessel)

47
Q

What type of hemorrhagic stroke can be asymptomatic?

A

subdural hemorrhagic stroke

48
Q

subdural hemorrhagic stroke is a(n) (arterial/venous) bleed

A

venous

49
Q

epidural hemorrhagic stroke is a(n) (arterial/venous) bleed

A

arterial

50
Q

(true/false) some subarachnoid hemorrhagic strokes do NOT have significant neuro deficits.

A

true

51
Q

What medication is only given to treat ischemic strokes (given within 3 hours)?

A

thrombolytics (to break up the clot)

52
Q

What is used to decrease metabolism and potentially prevent the penumbra from dying/slowing the process of necrosis after a stroke has occurred?

A

hypothermia

53
Q

Depression is present in ___% of stroke cases

A

30% –> most patients are given an anti-depressant after hospitalization to help with depression along with encouraging motivation for the recovery process

54
Q

___% of stroke cases end in death

A

15%

55
Q

Most people who die of stroke die from ___ strokes.

A

hemorrhagic strokes

56
Q

(ischemic/hemorrhagic) strokes have a better recovery outcome if the patient makes it through the initial period.

A

hemorrhagic strokes
(even though they do have a higher mortality rate)

57
Q

There will most likely be more deficits with (ischemic/hemorrhagic) strokes

A

ischemic strokes

Neuro (45 decks)

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