CVA Flashcards
What are the big risk factors for CVA?
Hypertension
Hyperlipidemia
Tobacco use
Diabetes
Race (black and african americans are more at risk)
Oral birth control
Age
Gender
Sickle cell
History of TIA
A-fib
What is an ischemic stroke?
An occlusion of a cerebral artery
What types of patients are in a relatively hypercoagulable state and have an increased risk of thrombus formation causing a stroke?
Patients taking chemo or oral contraceptives
What is penumbra?
Ischemic area that is still viable (injured by alive)
What is the goal related to penumbra?
Salvage the penumbra within 3 hours because otherwise it will die
What is a hemorrhagic stroke?
Bleeding within the brain parenchyma
What is the prognosis for a hemorrhagic stroke?
If the patient is older - the prognosis is better because the brain naturally atrophies and can make more room.
Depends on the location and size
How quickly the bleed shows up on a screen
What type of hematoma is seen commonly with skull fractures?
Epidural hematoma
What type of blood is involved with an epidural hematoma?
Arterial (oxygenated) blood
What is the dura mater doing with an epidural hematoma?
Peeled off of the skull
What type of blood is involved with a subdural hematoma?
Venous blood (deoxygenated)
What is the onset of subdural hematomas?
Can be 2-10 days
Are epidural or subdural hematomas more severe?
Subdural hematomas
What is a subarachnoid hemorrhage?
Bleed between the outer arachnoid membrane and the pia mater
What type of stroke is suspected with the complaint of “the worst headache of my life”?
Hemorrhagic stroke
What presentation may indicate irritation of the meninges?
Nuchal rigidity and photophobia
With what type of brain hemorrhage will you see blood within CSF in a lumbar puncture?
A subarachnoid hemorrhage
What are management techniques for caring for a patient with a subarachnoid hemorrhage?
Bedrest with sedation
Tight BP management
Surgical clipping ASAP
Prophylactic anticonvulsant
Nimodipine
Pressors + colloids
When is the re-bleeding risk for a subarachnoid hemorrhage the highest?
The first 24 hours
What is the acronym for recognizing a stroke?
BE FAST
B = balance
E = eyes
F = face
A = arms
S = speech
T = time
What type of imaging should be used for a stroke?
CT without contrast to exclude hemorrhage, if acute stage = MRI
What are the consequences of a stroke?
Depends on the area of damage
Motor / sensory deficit
Flaccidity (weakness)
Spasticity
Visual disturbances
Aphasia
Depression
Memory problems
Behavioral problems
What is aphasia?
Some degree of inability to speak or to comprehend
What is dysphagia?
Impairment of speech
