CVA Flashcards
How many stroke per year?
800,000
How many first time strokes?
600,000 3/4
How many recurrent?
200,000 1/4
Who is more at risk after age 85?
Women
Who is more at risk under age 85?
Men
What percent of strokes occur in 65 and younger?
30%
What percent of stroke survivors will have a 2nd stroke within 1 yr?
5-15%
What is the chance of having a 2nd stroke after 5 yrs?
24% women
42% men
Approximately how many people die each yr due to stroke?
143,000
1/18
Two types or stroke
38% hemorrhagic die in a month
8-12% ischemic die in a month
Comorbidities raise risk of stroke
Advanced age
Htn
Heart disease
Diabetes
Signs of stroke death
Loss of consciousness Large lesion Persistent Hemiplegia Multiple neuro deficits Past history of cva
Stroke is the leading cause of what in the US?
Long term disability
What % have ongoing hemiparesis?
Unable to walk unassisted?
Dependent in ADLs?
Aphasia?
50%
30%
26%
20%
What percent have clinical depression after stroke?
35%
What percent stroke patients will stay in long term facility?
26%
Cerebral Thrombus
Formation of clot in cerebral arteries or branch - brain
Cerebral infarction
Tissue death resulting from ischemia or occlusion of blood supply
Or atherothrombotic brain infarction ABI
Cerebral emboli
Composed of bits of matter formed elsewhere that travels through the blood stream where it lodges in a vessel causing occlusion and infarction
Intracerebral hemorrhage
Rupture of vessel bleed into brain
Primary cerebral hemorrhage
Without trauma, high bp, small vessels weakened causing aneurysm
Subarachnoid hemorrhage
Berry aneurysm
High bp
Non traumatic
Large blood vessels
Arterial venous malformation AVM
Congenital
Tangle of arteries increases risk of aneurysm leading to stroke
Reflexes
Involuntary instantaneous movement response to stimuli
Ischemic stroke they will come back
Babinski most commonly seen
Left Side
Speech and Lang impaired Difficulty processing commands Slow cautious Aware of impairments Disorganized problem solving Difficulty initiating tasks Memory impair Difficulty with positive emotions Apraxia-difficulty planning/ sequencing mvmt Perseverate: repeat word or task
Right side
Visual/perception impaired Neglect left side Difficulty with visual cues Impulsive Poor judgement Inability to self direct No awareness of defects Difficult with abstract problem solving Can't get big picture Can't perceive emotions Difficulty with neg emotions Performance fluctuates
ACA - anterior cerebral artery
Contralateral hemiparesis more LE than UE
Contralateral hemisensory loss involving LE than UE
Incontinence
Difficulty imitating apraxia
Abulia: lack spontaneity seems mute, can’t initiate(not common)
Reflexes: sucking and contralateral grasp
ACA CVA after rehab
Walk independently Use UE somewhat Struggle initiating task Delay in speaking Can't do bimanual task, piano
MCA
Contralateral hemiparesis more UE, LE less effected
Contralateral hemisensory loss in face, LE less effected
Motor speech impairment: Brocas, gap btn words (Non fluent aphasia left side)
Receptive speech impairment: wernickes-word salad impair audio Comprehension (dog,chair,fork)
Perceptual deficit: unilateral neglect depth
Limb kinetic apraxia can’t plan
Contralateral homonymous hemianopsia- miss half of room
Loss of conjugate gaze to opposite side - both eyes may not move together
Ataxia of contralateral limb: no idea what arm is doing
