cerebrovascular accidents Flashcards by Rauhiya Nassor

cerebrovascular accident

includes all disorders in which an area of the
brain is temporarily or permanently affected by ischemia or
bleeding and one or more of the cerebral blood vessels are
involved in the pathological process.

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death of tissue

infarction:

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hemorrhage

severe bleeding

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ischemia

restriction of blood supply to tissues, that can cause shortage of oxygen supply

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aneurysm

when part of artery wall widen abnormally or balloon out

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formation of blood clot inside blood vessels

Thrombosis

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Emboli

something that lodge into blood vessel and block it

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Clinical classification of CVA

A] Asymptomatic
B] CVA with focal brain dysfunction
1- Transient Ischemic Attack
2- Stroke a- Ischemic
b- Hemorrhagic
C] Vascular dementia
D Hypertensive encephalopathy

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asymptomatic cerebrovascular event

a stroke that doesn’t have any outward symptoms associated with stroke and the patient is unaware that they have suffered a stroke

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transient ischemic attack [mini stroke]

-episodes of temporary and focal dysfunction of vascular origin
-they have no persistent neurological deficits
-lasting 2 to 15 min
-its recurrent indicate thrombotic disease

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stroke

rapid developed clinical sign of focal or global disturbance of cerebral dysfunction
–lasting more than 24hrs
–no other cause rather than vascular origin
–can lead to death

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Focal neurological ocular symptoms

Motor symptoms
Sensory symptoms
Vestibular symptoms
Visual symptoms
Speech and language disorders
Behavioral/cognitive symptoms

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non focal ocular symptoms

feeling faint, lightheaded
bilateral visual impairments
urine or stool incontinence
confusion

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vascular dementia

it can be defined as a complex disease that develops as a result of ischemic or hemorrhagic stroke or ischemic-hypoxic brain lesions, characterized by severe cognitive involvement that can
disrupt activities of daily living

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hypertensive encephalopathy

It often occurs in patients with chronic hypertension
whose blood pressure is not well controlled.
-Headache
-unconsciousness
-epileptic seizures and
sometimes transient neurological problems can be
seen as result in rapid increase in blood pressure

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Epidemiology:

the branch of medicine which deals with the incidence,
distribution, and possible control of diseases and other factors relating to health.

classification of stroke

Hemorrhagic
Ischemic 80%

classifications of ischemic strokes

Large artery atherosclerosis 50%
Cardio embolism 20%
Lacunar stroke 20%
Of other determined etiolog 5%
Of non determined etiology 5%

Hemorrhagic stroke

intracranial bleeding occurs when blood vessel within the skull rupture or leaks

hemorrhagic stroke is examined into

Intracerebral -[bleeding within brain tissue] 10-20%
-has worth prognosis with 30days reported deaths
Subarachnoid

causes of intracerebral hemorrhagic stroke

hypertension
blood thinners
arteriovenous malformation
head trauma
bleeding disorders
trumors

Subarachnoid hemorrhagic stroke

caused by aneurysm
85%
subarachnoid area is filled with pressurized blood due to rupture

Symptoms of SAH

sudden onset of severe headache
nausea or vomiting
neck stiffness
sensitive to light
blurred vision
seizure

act FAST for stroke

Face
Arm
Speech
Time

right hemiplegia/left hemisphere

a) Visiomotor perception and memory are intact b) Global aphasia c) Agraphia, alexia d) Difficulty in right-left discrimination e) Dyslexia f) Difficulty in understanding the speech g) Emotional lability, anxiety h) Loss of calculation ability

left hemiplegia/right hemisphere

a) Visiomotor perceptual disorder (Perception of the environment, perception of spatial positions of objects) b) Location, time, person disorientation c) Left neglect d) Copying, geometric shape detection, problem in separating objects from the background, e) Impairment in the perception of depth and vertical position f) Loss of foresight and decision making g) Learning difficulties, concentration difficulties

sign and symptoms of brainstem stroke

 Difficulty in speaking  Difficulty in breathing  Problems with chewing and swallowing  There is partial or complete loss of hearing  Patient experiences blurry vision  There is weakness of the limbs  Patient experiences loss of sensation or numbness  Paralysis

sign and symptoms of brainstem stroke

blood supply of the brain

1. Anterior Circulation 1.1 Internal Carotid Artery 1.1.a Anterior Cerebral Artery 1.1.b Medial Cerebral Artery 1.2 External Carotid Artery 2. Posterior Circulation 2.1 Vertebral Artery 2.2 Basilar Artery 2.3 Posterior Cerebral Artery

neurological recovery

Cellular and molecular processes for regeneration and reorganization begin immediately after the stroke, just around the lesion region and partially in distant areas

Underlying factors in spontaneous neurological recovery

Elimination of harmful material Neuroplasticity

neuroplasticity

Brain ability to recognize itself by forming new neural connections throughout life It follows use it or lose it principle

Main mechanisms of neuroplasticity

*Collateral sprouting *Unmasking *Assumption of function by undamaged redundant neural pathways

stages to follow in neuroplasticity patients treatments

1] Acute care 2] Evaluation of stroke patients in terms of rehabilitation 3] Physiotherapy and rehabilitation 4] Traditional therapy 5] Neurophysiological approaches 6] Assistive modalities in stroke rehabilitation *electromyographic biofeedback *cryotherapy *functional electrical stimulation 7] Walking aids *canes *crutches *walkers