Cerebrovascular Accident (CVA = Stroke) Flashcards
1
Q
Incidence and prevalence
A
- 2nd most leading common cause of death in the world
- heart disease is the first
- 5th in the US
- leading cause of disability among older adults
- book states:
- 795,000 strokes a year
- someone in the U.S. experience a stroke in every 40 seconds
- someone in the U.S. dies of a stroke in every 4 minutes
2
Q
Description and definitions
A
- results from an interruption in the blood flow to the brain from a blocked or ruptured blood vessel
- the inadequate supply of oxygen and nutrients to the brain leads to brain damage
- can occur in the brain, cerebral hemispheres, cerebellum, or brain stem
- the functional loss depends on the site and the severity and extension of the stroke
- CVAs are divided into 2 main categories:
- ischemic = a clot
- hemorrhagic = an opening in the artery
3
Q
Transient ischemic attacks (TIA)
A
- also known as “mini strokes”
- occur when the blood supply to your brain is briefly blocked by a clot or narrowed artery
- narrowed arteries are usually caused by plaque = a buildup of fat, cholesterol, calcium, and other substances
- the symptoms of a TIA are the same as in a stroke, the difference is that in a TIA, the blockage is temporary and the blood flow returns on its own
- since blood flow is interrupted only for a short time, symptoms of a TIA usually go away within an hour
- because the symptoms go away, many people ignore them = BIG MISTAKE because they can be a red flag warning you that a major stroke could happen and often within the next 48 hours
4
Q
CVA (characteristics from the table)
A
- cerebrovascular accident (CVA), also known as stroke, is a sudden interruption of blood flow to the brain that can cause permanent damage
- duration of symptoms = permanent
- severity of symptoms = can be severe
- risk of recurrence = high
- prognosis = can be poor
5
Q
TIA (characteristics from the table)
A
- transient ischemic attack (TIA) is also known as a mini stroke, a temporary interruption of blood flow to the brain that causes stroke-like symptoms, but the symptoms typically lasts only few minutes or hours (TIAs are a warning sign of a more serious stroke)
- duration of symptoms = minutes to hours
- severity of symptoms = mild to moderate
- risk of recurrence = high
- prognosis = usually good
6
Q
Classification of CVA
A
- stroke = ischemic (85%) and hemorrhagic (15%)
- ischemic = thrombotic and embolic (MC)
- hemorrhagic = intracerebral hemorrhage and subarachnoid hemorrhage
7
Q
Thrombosis ischemic CVA
A
- blood clot forms within one of the arteries of the brain, causing obstruction where it is formed
- typically these arteries have already been damaged by atherosclerosis
- most common cause of CVA
- symptoms = stuttering, progressive symptoms over several hours or days, onset during sleep is common, and TIAs prior to an actual stroke
8
Q
Atherosclerosis
A
- rough irregular fatty deposits from in the arteries
- clots occur when 66% of the vessel is blocked
9
Q
Lacunar strokes
A
- small infarcts (clots) located usually in the deep brain structures such as basal ganglia, thalamus, pons, internal capsule, and deep white matter
- 20-25% of ischemic strokes
- the strokes are very small
- minimal neurological symptoms are often present and may go undetected
10
Q
Embolism
A
- occurs when a clot that has formed elsewhere (thrombus) breaks off (embolus), and travels to the brain, reaches an artery too small to pass through and blocks that artery
- effects are like a thrombosis, just in a different origin
- typically occur during daytime activities
- can be precipitated by sudden movements which raised blood pressure and dislodges a clot
- symptoms maximal at onset but they can break through, move and then get stuck again
- no real history of TIA
11
Q
Hemorrhagic CVA
A
- 15-20% of CVAs
- caused by a rupture in a blood vessel with resultant bleeding into or around the cerebral tissue
- can also be caused by an aneurysm
- intracerebral (ICH)
- subarachnoid (SAH)
12
Q
Aneurysm
A
- an artery in a weak area that fills with blood in or around the brain bulges
13
Q
Intracerebral hemorrhage (ICH)
A
- bleeding into the brain substance
- higher percentage of death than ischemic stroke
- disruption of brain function of that region
- blood irritates the brain causing swelling
- blood forms a mass called hematoma
- increased pressure destroys these areas
- oxygen deprivation
- when the bleeding stops, a clot will form = may recede, break down, and be reabsorbed
14
Q
Subarachnoid hemorrhage (SAH)
A
- bleeding within the brains surround membranes and cerebrospinal fluid (CSF)
- 2-5% of all CVAs
- 85% of these SAH are caused by leakage of blood for an aneurysm
- “worst headache ever”
15
Q
Modifiable risk factors
A
- high blood pressure (HTN) = “silent disease”
- most significant controllable risk factor
- the higher the pressure, the faster the blood flows through the system and wears down the arterial walls, making them thinner
- 110/70 = normal blood pressure (used to be 120/80)
- atherosclerosis
- lack of physical activity
- waist-to-hip ratio = increased abdominal adiposity
- apolipoprotein
- smoking = causes one of every 3 deaths
- cardiac causes
- alcohol consumption
- high blood sugar levels (diabetes)
- psychosocial factors
