CVA Flashcards
cerebral vascular accident
problem with blood supply to brain
Risk factors
HTN, high cholesterol
Tobacco, diabetes
Birth-control, increased age, men
Sickle cell anemia
History TIA, a fib
Ischemic stroke
occlusion of cerebral artery
Due to thrombus, embolus
Darkened area on CT
Ischemia
decreased blood supply
Oxygen deprivation
Neurodeficits within one minute
Continued loss of supply – irreversible damage
Thrombotic cause of stroke
atherosclerosis – damage to endothelium, plaque forms, narrows vessel
Hypercoagulable state – inappropriate forming of clots
embolic cause of stroke
Cardiac- mural thrombus, A fib
Venus clot of atrial septum defect
Thrombus of vegetation valves
patent foramen ovale
hole leading to clot formation, moving from right to left atria
A fib cause
left atrial thrombus
Inability of atria to contract, ineffective pooling to blood, pooling, clot formation
penumbra
ischemic area that is still viable
goal- Salvage within three hours
Hemorrhagic stroke
bleeding within brain parenchyma
Due to long, severe hypertension
can occur within minutes to hours
Can be due to aneurysm
larger area affected
Increased intracranial pressure with inflammation
Herniation
should you give anticoagulate hours to someone with a hemorrhagic stroke
No, I can make the bleeding worse
prognosis of hemorrhagic stroke
Due to age, location and size
How rapid the bleeding causes brain, distortion and shift
epidural hemorrhage
Due to skull fracture, arterial
Lots of bleeding, less severe injury
above Dura, under skull
subdural hemorrhage
Bridging veins
Brain moved within skull, vessels don’t
Rapid decline – severe injury
Can also be slow – 2 to 10 days
Below Dura
subarachnoid hemorrhage
Between outer arachnoid and pia matter
Area filled with CSF – blood tinged
Rupture of cerebral aneurysms, anterior venous malformation
what is the most common type of aneurysm to rupture in the brain?
Barry aneurysm
presentation of hemorrhage, stroke
30 to 60 years
Serious disabilities
Worst headache ever
Rapid change in LOC
Irritation of meninges – neck
rigidity, photophobia
subarachnoid hemorrhage care
Bedrest with sedation
** BP range
Surgical clipping
Prophylactic anticonvulsant
nimodipine
triple H – pressers, Colloids, hemodilution
BEFAST
Balance – loss, HA, dizzy
Eyes – loss, pupils
Face– symmetry
Arm– weakness
Speech– difficulty
Time-call 911
what is the first form of treatment for a stroke?
CT scan without contrast to exclude hemorrhage
Better in acute setting
what type of procedure can be performed to remove a clot?
Penumbra procedure
Left-sided brain consequences of stroke
More focused on analytics and communication
Right sided consequences of stroke
More focused on shapes, art, music
dysphagia
difficulty swallowing
Evaluate risk for aspiration
Motor and sensory deficits
Due to neglect
No sensory input from damage
Decreased muscle coordination
Flaccidity
weakness, limpness
Contralateral side
spasticity
Can cause contractures
Occurs within six weeks
Visual disturbances
Contralateral field blindness
Homonymous hemianopia
Aphasia
Language disability
receptive aphasia
Able to communicate, difficulty understanding
expressive aphasia
Difficulty speaking, able to understand
Dysphasia
Impairment of speech
dysarthria
Imperfect speech, use of incorrect words
behavioral problems
increased emotional response
May underestimate own abilities
Slow reaction time
Hesitant and cautious
Apathetic, confused, disoriented
What are other consequences that can occur from a stroke?
memory problems and depression
