Cerebrovascular Accident Flashcards
define a stroke/ CVA
part of the blood supply to the brain is impaired, which leads ot cell death.
what are the 2 types of CVA
infarct
haemorrhage
define a transient ischaemic attack
temporary reduction in blood supply to the brain, symptoms resolve within 24 hours
describe the pathophysiology of an infaction
- a blood clot or thrombus prevents blood flowing to some regions of the brain.
- 85% of all strokes
what are risk factors that can cause in infarct CVA
- atherosclerotic disease
- vasculitis
- arterial dissection
define a thrombus
blood clot formation within the vessel
define an embolus
a clot that originated from another location in the body e.g. heart and it travels to the brain
describe the pathophysiology of a haemorrhagic cva
- 15%
- due to bleeding into the brain by the rupture of a blood vessel
define intracerebral hemorrhage
bleeding into the brain parenchyma
define subarachnoid hemorrhage
bleeding into the subarachnoid space
what causes a primary injury
due to the compression of brain tissue by the hematoma and an increase in the intracranial pressurewh
what causes a secondary injury
all these contribute:
the inflammation, disruption or the blood brain barrier, edema, overproduction of free radicals such a rective oxygen species, glutamine-induced excitotoxity, and release of haemoglobin and iron from the clot
what is the circle of willis
the main structure that provides constant blood flow to different area of the brain
what are the main arteries of the brain
- anterior cerebral artery
- middle cerebral artery
- posterior cerebral artery
what are common symptoms of a CVA
dependent on where bleed occurs
- cognitive decline
- drop in consciousness
- visual chnages
- speech and swallow problems
- weakness; unilateral, face, upper and lower limb
- tonal changes
- sensory defecit
- altered spatial awareness
- balance deficit/ ataxia
- reduced function
what are medical management techniques for an infarct
- thrombolysis: clot busting drug
- thrombectomy: surgically remove clot
- blood thinners
- surgery to decompress and relieve the intracerbral pressure
- treat source of embolus e.g. atrial fibrillation
what are medical management techniques of a haemorrhagic stoke
- surgery
- remove haemotoma
- decompress to relieve intracranial pressure
- aneurysm coiling/ clipping/ wrapping etc.
- blood pressure management
how can physiotherapy benefit a stoke patient
- symptom specific relief: tone management, power, sensation
- rehabilitation and goal setting
- MDT management
- onwards referral
- education
- family support
- increase independence
- aids and adaptations
- imporve mobility
