cerebrovascular accidents Flashcards
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.
death of tissue
infarction:
hemorrhage
severe bleeding
ischemia
restriction of blood supply to tissues, that can cause shortage of oxygen supply
aneurysm
when part of artery wall widen abnormally or balloon out
formation of blood clot inside blood vessels
Thrombosis
Emboli
something that lodge into blood vessel and block it
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
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
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
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
Focal neurological ocular symptoms
Motor symptoms
Sensory symptoms
Vestibular symptoms
Visual symptoms
Speech and language disorders
Behavioral/cognitive symptoms
non focal ocular symptoms
feeling faint, lightheaded
bilateral visual impairments
urine or stool incontinence
confusion
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
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
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
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
blood supply of the brain
- Anterior Circulation
1.1 Internal Carotid Artery
1.1.a Anterior Cerebral Artery
1.1.b Medial Cerebral Artery
1.2 External Carotid Artery - 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
