Chap 9 Cerebrovascular Accident (CVA)

Question 1

What are types of CVA?

Answer 1

• Ischemic
• Hemorrhagic
• Intracerebral
• Subarachoid
• Thrombotic
• Embolic

Question 2

CVA epidemiology?

Answer 2

• Second leading cause of death world wide – 4.6 million annually
• United States’ third leading cause of death and disability – 700,000 cases per year – 100,000 recurrent strokes per year

Question 3

Atrial Fibrillation?

Answer 3

– Affects 2 million Americans – Two atria quiver
– Heart pumps blood inefficiently resulting in pooling of blood – leads to thrombi (blockage at point of origin)
– Increases risk of CVA five fold

Question 4

What are the risk factors of CVA?

Answer 4

• Oral contraceptives
• Menopause due to estrogen changes
• Diabetics
• Familial history of CVA
• Carotid Bruit – abnormal sound in carotid artery

Question 5

Ischemic CVA

Answer 5

• Blockage in cerebral blood vessel
• Thrombus or embolus (foreign object that at a distant site, circulates in bloodstream and becomes lodged in blood vessel)
• 85% CVAs – 60% thrombotic; 40% embolic

Question 6

what are the signs and symptoms of Hemorrhagic CVA?

Answer 6

• Inability to stand or walk = Papillary malalignment
• Nausea or vomiting
• Altered level of consciousness – yawning to coma

Question 7

what are the signs and symptoms of Ischemic CVA?

Answer 7

• Altered level of consciousness – (yawning to coma) – loss of consciousness uncommon
• Pupils unequal and dilated
• Confusion
• Dizziness
• Change in balance or coordination (ataxia)
• Vision changes – loss of half the visual
  field
• Deviation of tongue
• Difficulty swallowing (dysphagia) = Speech changes

Question 8

what is Subarachnoid CVA?

Answer 8

• Occurs when blood vessel on surface of brain ruptures and bleeds into subarachnoid space
• Blood places pressure on cerebellum causing pressure and damage to brain cells

Question 9

what is Intracerebral CVA?

Answer 9

• Twice as common
• Occurs when defective artery within the
  brain bursts
• Surrounding tissue fills with blood
• Blood places pressure on adjacent tissues
• Due to ruptured artery other areas of brain ischemic leading to additional damage

Question 10

Hemorrhagic CVA

Answer 10

• Rupture of a blood vessel
• 15% of all CVAs
• Factors: hypertension, anticoagulation, tumor, substance abuse, aneurysm (weakening in blood vessel wall – with added pressure ruptures)

Question 11

Ischemic CVA

Answer 11

• Core - central zone of ischemic tissue
• Penumbra – surrounding tissue receiving diminished blood supply
• • Potentially salvageable if blood supply restored quickly