CVA Flashcards
what is the prevalence of stroke?
3rd most frequent cause of death
Leading cause of serious long-term disability
how are older people affected by stroke?
75% of strokes occur in people >65
>55 y/o risk of stroke doubles
what is the determining factor of how a stroke will affect you?
TIME
Greater time brain is starved from not getting oxygenated blood, the more damage
what are the risk factors for stroke?
hypertension Coronary artery disease Atrial Fibrillation Diabetes (2-4 x’s greater risk) Tobacco Use (doubles risk) Cholesterol levels Alcohol Genetic Risk
what is the most common stroke?
ischemic
what are types of ischemic stroke?
Global - Large-vessel (carotid, middle cerebral)
Can affect large parts of brain (hemispheres)
Focal – Small vessel (lacunar stroke)
what are the types of hemorrhagic stroke?
Intracerebral
Subarachnoid
Subdural
what occurs during an ischemic stroke?
Infarct: Blood and oxygen supply blocked
Stenosis: narrowing of the artery due to plaque buildup
Embolism: Blood clots
what is an umbra vs penumbra?
umbra = central infarct area penumbra = ischemic tissue that may recover
how fast does infarction area die?
Umbra: where tissue start to die 1st (within 6 minutes)
Penumbra: can be viability if blood is perfused back to it fast enough (over 6 minutes)
how does hemorrhagic stroke occur?
Weak artery wall expands like a balloon (aneurysm)
The thin wall burst
Or, Artery wall becomes brittle and thin (crack and bleed)
what is intracerebral hemorrhage?
bleeding into the brain
what is Subarachnoid hemorrhage?
bleeding under the meninges in subarachnoid space
what type of hemorrhagic stroke has best outcome?
Subarachnoid better than subdural bc more space for blood to pool in subdural space and symptoms take longer to appear
why does aging population have to be careful of hemorrhagic stroke?
atrophy of brain creating more space for brain to move in skull.
When elderly fall brain moves in intercerebral space and arteries are torn causing more risk to hemorrhagic stroke
what is a transient ischemic attack?
“mini-stroke” that results in no lasting damage
how long does TIA last?
Typically last 10-15 minutes
(Piece of plaque moves on after short periods of time)
Symptoms clear up within 24 hours
what is a TIA a risk factor for?
25% have an ischemic attack within 5 years
how is TIA txed?
Medication is blood thinner (could be asprin)
what are the effects of stroke?
Physical Sensory Cognitive deficits Aphasia Emotions
what are left hemisphere effects of stroke?
Aphasia Right Hemiparesis Right sided sensory loss Right visual field defect Dysarthria Difficulty reading, writing, or calculating
what are right hemisphere effects of stroke?
Left visual field defect Left hemiparesis Left-sided sensory loss Left gaze Dysarthria Visuospatial defects Anosognosia left-sided neglect
what is Anosognosia?
lack of self-awareness
Not aware of their own deficits
what is Intrapersonal vs. Extrapersonal neglect?
intrapersonal = don’t take care of left side of body extrapersonal = environmental neglect (pay attn to one side of visual field)
how do you test neglect?
double simultaneous stimulation to both sides (tactile, auditory) during simultaneous, there is extinguishing of neglected side
what are other side effects of stroke?
Fatigue
Emotional Lability
Planning Deficits
Dysphagia
what do you tx psychologically with stroke patients?
Tx for depression, anxiety, frustration, & anger
