Cerebrovascular Accident (CVA)

Question 1

Left Hemisphere CVA

Answer 1

weakness/paralysis of right side
increased frustration/ decreased processing
possible aphasia (expressive/receptive/global)
possible dysphagia
possible motor apraxia (ideomotor/ideational)
decreased discrimination between left and right
right hemianopsia

Question 2

Right Hemisphere CVA

Answer 2

weakness/paralysis of left side
decreased attention span
left hemianopsia
decreased awareness/judgement
memory deficits
left inattention
decreased abstract reasoning
emotional lability
impulsive behaviors
decreased spatial reasoning

Question 3

Brainstem CVA

Answer 3

unstable vital signs
decreased consciousness
decreased ability to swallow
weakness/ paralysis on both sides of body

Question 4

Cerebellar CVA

Answer 4

decreased balance
ataxia
decreased coordination
nausea
decreased ability for postural adjustment
nystagmus

Question 5

Transient Ischemic Attack (TIA

Answer 5

linked to artherosclerotic thrombus causing temporary interruption of bloodflow to brain
effects similar to CVA, but resolve quickly (24-48 hrs)
most common in carotid/ vertebrobasilar arteries
may indicate future CVA

Question 6

Completed Stroke

Answer 6

CVA that presents with total neurological deficits at onset

Question 7

Stroke in Evolution

Answer 7

CVA caused by thrombus that gradually progresses

total neurological deficits not seen for 1-2 days post onset

Question 8

Ischemic Stroke

Answer 8

Embolus: (20% of CVAs) associates w/ Cardio Vascular Disease, solid/liquid/gas causing occlusion of blood vessel- tissues distal to infarct sustain more permanent damage

Thrombus: atherosclerotic plaque develops until it occludes the artery, usually occurs during sleep/upon awakening after myocardial infarction/post op- extremely variable- symptoms can appear in min-days

Question 9

Hemorrhage

Answer 9

(10-15% of CVAs) abnormal bleeding in brain due to rupture in blood supply. Infarct= disrupt of O2 and compression from accumulation of blood, precipitated by hypertension/tension
50% of deaths happen within 1st 48 hours

Question 10

Risk Factors

Answer 10

Primary: Hypertension, cardia disease/arrhythmias, diabetes mellitus, cigarette smoking, TIA

Secondary: Obesity, high cholesterol, behaviors related to hypertension (excessive stress, salt intake), physical inactivity, increased alcohol consumption