CVA

Question 1

Etiologic categories

Answer 1

Cerebral thrombosis - formation of clot
Cerebral embolism - traveling bits of matter produce occlusion
Cerebral hemorrhage - abnormal bleeding from rupture of BV

Question 2

Risk factors

Answer 2

Atherosclerosis
Hypertension
Cardiac disease
Diabetes
TIAs

Question 3

Pathophys

Answer 3

Cerebral anoxia - lack of oxygen supply to brain (irreversible damage begins after 4 to 6 minutes)
Cerebral infarction - irreversible cellular damage
Cerebral edema - accumulation of fluids in brain

Question 4

Neurovascular clinical syndromes - Internal carotid artery (ICA) syndrome -

Answer 4

ICA arises off common carotid artery - gives off ophthalmic branch and terminates in ACA and MCA

Question 5

Neurovascular clinical syndromes - Internal carotid artery (ICA) syndrome - ACA syndrome

Answer 5

ACA supplies ant 2/3 of medial cerebral cortex

Occlusions produce minimal deficits because circle of willis

Question 6

Neurovascular clinical syndromes - Internal carotid artery (ICA) syndrome - MCA syndrome

Answer 6

MCA supplies lateral cerebral cortex, BG, and large portions of internal capsule

Question 7

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome

Answer 7

2 vertebral arteries arise off subcalvian and supply ventral surface of medualla and post/inf cbm before joining to form basilar artery
Basilar supplies ventral pons and terminates in the PCA

Question 8

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome - Medial medullary syndrome

Answer 8

occlusion of the vertebral anterior branch of the lower basilar artery

Question 9

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome - lateral medullary (wallenberg’s) syndrome -

Answer 9

occlusion of vertebral, posterior inferior cerebellar, or basilar artery

Question 10

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome - basilar artery syndrome

Answer 10

produces brainstem s/s and PCA s/s

locked in syndrome (basilar artery occulsion at level of pons)

Question 11

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome - medial inferior pontine syndrome

Answer 11

occlusion of the paramedian branch of basilar artery

Question 12

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome - lateral inferior pontine syndrome

Answer 12

occlusion of the anterior inferior cerebellar artery

Question 13

Neurovascular clinical syndromes - Vertebrobasilar artery syndrome - PCA syndrome

Answer 13

PCA and posterior communicating arteries supply midbrain, temporal lobe, diencephalon, and post 1/3 of cortex
occlusions proximal to post communicating artery produce minimal deficits because of collateral circulation

Question 14

Sequential recovery stages

Answer 14

1 - initial flaccidity
2 - emergence of spasticity, hyperreflexia, synergies
3 - voluntary mvmnt possible, but only in synergies, spasticity strong
4 - voluntary control in isolated joint movements emerging, corresponding decline of spasticity and syergies
5 - inc voluntary control out of syergies, coord deficits present
6 - control and coordination near normal

Question 15

Pts with lesions of left hemisphere (right hemiplegia) are often

Answer 15

slow, cautious, hesitant and insecure

Question 16

Pts with lesions of right hemisphere (left hemiplegia) are often

Answer 16

impulsive, quick, indifferent, exhibit poor judgment and safety, overestimate their abilities while underestimating their problems