- obstruction go blood flow - 80% of all strokes

- blood clot blocks flow - related to atherosclerosis

- 20% of stokes - vessels in the brain that rupture

out of 100 stroke patients: - 15 die - 10 recover completely - 25 recover w/ minor impairment - 40 severe imparment - require long term care

cerebrovascular and infectious disorder Flashcards by Joelle Balanag

cerebrovascular disorders

interruption of blood flow to the brain
temporary or long-lasting
similar to blood flow to heart

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transient ischemic attack

transient interruption of perfusion to brain
“TIA”
warning of impending stroke
interruption to the brain: short term

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stroke: def

ischemia to the brain to the extent that neutrons die

- “brain attack”

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stroke: prevalene

about every 10 mins, 3rd leading cause of death

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stroke: types

ischemic

- hemorrhagic

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ischemic stroke

obstruction go blood flow

- 80% of all strokes

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ischemic stokes - 2 types

thrombotic

- embolic

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thrombotic

blood clot blocks flow

- related to atherosclerosis

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thrombotic - risk factors

smoking
hypertension
dyslipidemia
high cholesterol
inactivity
diabetes

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embolic “thromboembolic”

bits of lot from elsewhere

- usually comes from the heart with a particular heart rhythm

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ischemic stroke: pathophysisology

sensitive to change in o2
atherosclerosis
secondary injury

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secondary injury in stroke

cell injury, inflammation, edema ischemis

- infraction of brain tissue due to lack of blood flow

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ischemic stroke: treatment

need CT first

- possible fibrinolytic “clot busters”

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hemorrhagic stroke

20% of stokes

- vessels in the brain that rupture

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hemorrhagic stroke - types

subarachnoid

- intercerebral

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hemorrhagic - risk factors

hypertension
cerebral aneurysms
arteriovenous malformation

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arteriovenous malformation

missing capillaries

- risk for bleeding because there is such a pressure change

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hemorrhagic stroke: management

aneurysm

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stroke: manifestations (five warning signs)

weakness
trouble speaking
vision problems
headache
dizziness

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stroke: manifestations (quick assessment)

FAST
facial drupe
arm drift
speech
time to call 911

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stroke: sequelae

out of 100 stroke patients:

15 die
10 recover completely
25 recover w/ minor impairment
40 severe imparment
require long term care

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left cerebrum - if stroke

motor deficit on opposite side
pupils change same side
reading
talking
learning new memories

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right cerebrum - if stroke

motor deficit on opposite side
pupils change same side
left-sided neglect (25%)

brain stem - if stroke

vital functions

cerebellum - if stroke

- balance | - co-ordination

aphasia - types

- wernicke's aphasia - broca's aphasia - global aphasia

wernicke's aphasia

unable to understand spoken or written language

broca's aphasia

missing connecting words

prosopagnosia

face blindness

stroke: other complications

- aphasia - prosopagnosia - foreign accent syndrome

stroke: levels of prevention

- primary - secondary - tertiary

primary prevention

- smoking - hypertention - dyslipidemia

secondary prevention

FAST

tertiary prevention

- ischemic stroke (clot busters) | - hemorrhagic storke (surgery to stop bleeding)

CNS infection: classifications

- meningitis | - encephalitis

meningitis

meningitis and CSF

encephalitis

the brain parenchyma (brain tissue) | - most commonly cause by mosquito viruses

meningitis: types

- categorized by organism | - categorized by onset

catergorized by type of organism

- bacterial - viral - fungal

categorized by onset

- actue | - chronic

meningitis: bacterial

- rapid onset - high mortality rate (25-100%) - organisms vary

bacterial meningitis: manifestations

- meningeal signs - infectious signs - neurological signs

meningeal signs

- kerning's sign - brudzinski's signs - nuchal rigidity

infectious signs

- fever, tachycardia, chills etc | - lumbar puncture to culture CSF

neurological signs

- increased inter-cranial pressure signs

kernig's sign

- can't straighten leg | - stiffness in leg

brudzinski's sign

if you bring the head up the legs will follow

meningitis: viral

- most tend to be enteroviruses - mumps - herpes 1 and 2 - epstein barr virus - influenza A and B

viral meningitis: manifestations

- much milder

viral meningitis: treatment

antiviral, supportive, corticosteroids

meningitis: complications

- hydrocephalus

hydrocephalus

- water on the brain - excess cerebrospinal fluid - congenital or acquired - communicating or non-communicating - flow is the same, amount is excessive

communicating

impaired absorption or overproduction of CSF - infection - head injury - tumour

non-communicating

obstruction of CSF flow between ventricles - congenital abnormality - compression by a tumour

congenital hydrocephalus

- causes enlargement of head | - shunts to drain CSF