Cerebral Vascular and Infectious Disorders Flashcards
what is the leasing cause of disability
cerebrovascular accident
what are the major risk factors for a cerebrovascular accident
- hypertensio, and type 2 diabetes
whata re the three types of cerevrovascular accidents
- Ischemic
- hemmorrhagic
- hypoperfusion
what are the risk factors for a cerebrovascular accident
- poorly or uncontrolled hypertension
- smoking
- insulin resistance and diabetes melitus
- polycythemia, thrombocythemia
- high LDL; low HDL
- congestive heart disease and peripheral vascular disease
- hyperhomocysteinemia
- artrial fibrillation
Ischemic stroke
- obstruction of blood flow to the brain caused by thrombus, embolism, or hypoperfusion (decreased blood volume or heart failure)
transient ischemic attacks
- last under an hour
- focal cerebral ishemia
transient ischemic attacks signs and symptoms
weakness, numbness, sudden confusion, loss of balance, sudden or severe headache
thrombotic stroke
- atrial occlusions caused by thrombi in arteries supplying brain or inter cranial vessels
thrombic stroke risk factors
- increased coagulation or inadequate cerebral perfusion
thrombotic stroke most often developes for
atherosclerosis
embolic stroke
- fragments that break from thrombus formed outside the brain or from fat, air, tumour, bacteria or foreign body
embolic stroke risk factors
atrial fibrillation, potential for pooling of blood, left artial or centricular disease, recent myocardial infraction, tumours
hypoperfusion stroke occurs
if there is carotid artery occlusion
hypoperfusion stroke is caused by
cardiac failure, pulmonar embolism or hemorrhage that results in inadequate blood flow to the brain
ischemic stroke signs and symptoms
Weakness
Trouble Speaking
Vision Problems
Headache
Dizziness
broad signs and symptoms of a stoke acronym
FAST
Face - is it drooping?
Arms - can you riase both?
Speech - is it slurred or jumbled
time - to call 911 right away
hypoperfusion ischemic stroke symptoms
are bilateral and diffuse
embolic stroke treatment
- prevent further embolisation
- anticoagulation therapy
- correct primary problem (fat, embolus, tumour, cardiac condition)
intracrainial aneurysms is caused by
arteriosclerosis, congenital abnormality, cocaine use, inflammation, vascular sheer wall stress
intercranial aneurysms is most often located at the
bifurcation or near the circle of Willis, vertebrobasillar arteries, carotid arteries
intercranial aneurysms signs and symptoms
often asymptomatic
- dizziness or headache
if cranial nerves are effected
stoke on left side shows left sided deficits
arteriovenous malformation (AVM) signs and symptoms
- chronic headache
- 50% will have seizures
arteriovenous Malformation (AVM)
- congenital vascular lesion
- mass of dilation vessels instread of a capillary bed
- direct shunting of arterial blood into the venous system
subarachnoid hemorrhages risk factors
- intracranial aneurysm, AVM, hypertension, family history of subarachnoid hemorrhage, sustained head injury
complication of subarachoid hemorrhages
Vasospasm
- causes decreased cerebral blood flow, ischemia, and potential infract
subarachnoid signs and symptoms
Early: headache, changes in mental staus of LOC, nausea or vomiting
ruptured subarachnoid hemorrhages signs and symptoms
sudden throbbing, explosice headache with nausea and vomiting, visual disturbances, motor deficits, decreased LOC, neck stiffness, photophobia, blurred vision due to meningeal irritation
subarachoid hemorrhages treatment
- controlling ICP, improving cerebral perfusion pressure, prevent ischemia and hypoxia or neural tissues, and avoid rebleeding
intraparenchymal aneurysms treatment
stop bleeding, control intercrainal pressure, prevent rebleed, prevent rebleed, prevent vasospasm, surgical intervention (rutured aneurysms, AV malformations, and subarachnoid hemorrhage)
intracranial aneurysms treatment
- control hypertension, prevent vasospasm, microvascular clipping or endovascular coild
AV malformation treatment
- surgical excision, embolization, radiotherapy
outcome of left side stroke
- right sided weakness or paralysis
- problems with speech (speaking and understanding)
- Visual (cant see the right side of vision)
- depression and cautiousness
- impaired cognitive abilities
- memory problems
right sided stroke outcomes
- left sided weakness or paralysis
- denial of paralysis (“left neglect” - lack of response to stimuli on the left side)
- visual (cant see left side)
- depth perception
- recognition of body parts
- memory problems
- depression, inappropriate behaviours, impulsivity
cerebellum stroke outcomes
- problems with gait
- dizziness
- headache
- nausea and vomiting
brainstem stroke outcomes
- respiratory and cardiac concerns
- tempurature control
- balance/coordination
- weakness or paralysis
- dysphagia, dysphasia
- vision prpblems
- coma or death
example fo left sided neglect
when writing the number 12 only writes the number 2
example of primary prevention for stoke
- education
- yearly checkups
example of secondary prevention for stroke
- FAST
- lifestyle changes: diet, sodium intake, exercise, wight, smoking, and alcohol intake)
tertiary prevention fro stroke examples
treatments for stoke
headache
- symptom of an underlying disease (brain tumor, CVA< meningitis)
Cluster headache
pain is in and around one eye
tension headache
pain is like a band squeezing the head
- mild to moderate headache felt on both sides of the head
migraine headache
- pain, nausea and visual changes are typical of classic form
migraine
episodic neurologic disorder headache lasting 4-72 hours
individuals who suffer from migraines are at higher risk of
epilepsy, depression, anxiety, cardiovascular disease and stoke
premonitory phase
- hours to days before the onset of a headache
SYMPTOMS: tiredness, irritability to concentrate, and stiff neck
migraine aura
- may last 1 hour
SYMPTOMS: visual (flashes of light), sensory (tingeling on one side of the body), or motor (inability to speak clearly)
what perventage of people report having migraine aura
1/3
headache phase
throbbing and spread to entire head
- accompanied by nausea, vomiting, fatigue, and dizziness
- may last 4-72 hours
recovery phase
- irritability, fatigue, depression
- lasts hours to days
management of headaches
- identify and avoid triggers
- sleeping at the onset
- pharmacy for prevention and treatment
- rebound headaches (overuse of analgesics)
- manage weight, avoid caffeine
Cluster headaches occur
in the autonomic division of CN5 (trigeminal nerve)
cluster headache is described as
servere, stabbing, throbbing
cluster headache occurs predominetly in
men between 20 and 50 years of age
cluster headache treatment
- avoid triggers
- treated with medications and oxygen
what is the most common type of headache
most common
what is the average age of onset for tension headaches
teenage years
tension headache treatment
- mild treated with ice
- moderate treated with aspirin and NSAIDS
- possibly antidepressants, botox injections
- long term use of analgesics, caffeine, antihistamines should be avoided
meningitis
- inflammation of the meninges of the brain and spinal cord
bacterial menigitis is caused by
neisseria meningitidis and streptococcus pneumoniae
acute menigitis
< 1 day
subacte menigitis
1-7 days
chronic meningitis
> 7 days
bacterial menigitis risk factors
- Invasive injury or procedure
- Respiratory/ear infection
- Immunocompromised individuals
- Overcrowded living conditions
Aseptic Viral Meningitis
- results form infection or secondary to disease (enteroviral viruses, mumps, herpes type 2, measles
risk factors for aseptic viral menigitis
infants, children, older adults, malnourishmnet, immunosuppression, and CNS trauma
treatment of aseptic viral meningitis
antivirals, and supportive corticosteriods
viral meningitis neurological symtoms
- changes in LOC
- focal defitics
- seizures
infectous meningitis signs
- fever, tachycardia, chills, ect.
clinical signs of viral meningitis
- headache, stiff neck, photophobia, + kernig sign, + brudzinski’s sign
brudzinski’s sign
severe neck stiffness causes hips and knees to flex when the neck is flexed
kernig’s sign
severe stiffness of the hamstrings case an inability to straighten the leg when the hip is flexed to 90 degrees
Diagnostics for meningitis
- brudzinski’s sign
- kernig’s sign
- lumbar puncture
- sinus and skill xrays
- CT scan/MRI
- blood cultures
- WBC
meningitis complication
- Hearing loss – Most common
- Seizures
- Increased ICP & cerebral edema
- Altered mental status
- Cerebrovascular damage
Intellectual deficit
meningitis complications in children
- sensory hearing loss, epilepsy, hydrocephalus, subdural effusions, subdural empyema
hydrocephalus
accumulation of CSF in the brain
sudural effusions
fluid
subdural empyema
pus
encephalitis
inflammation of the parenchyma of the brain or spinal cord due to infection
encephalitis signs and symptoms
similar to meningitis but are usually sicker
- seizures, decrease LOC, aphasia, paralysis, ataxia (gait) abnormalities, nystagmus (eye), hyperkinesia, severe personality changes
encephalitis potential outcomes
memory problems, personality and behaviour changes, speech problems, epilepsy, physical difficulties, depression and fatigue
