CVA Flashcards
what ratio of deaths associated with CVD were due to stroke in 2018?
1 in 6 deaths from CVD were due to stroke
how often does someone in the US have a stroke? how often does someone die from a stroke?
every 40 seconds; every 4 minutes
about how many people per year have a stroke in the US
about 800,000
what percentage of strokes are ischemic?
87%
how much does stroke-related care cost the US each year?
about $46 billion
how does high BP relate to stroke
77% of first time stroke patients have a BP > 140/90
how does heart rhythm relate to stroke?
A fib increases risk of stroke 5x
how much can mod-vigorous activity reduce risk of ischemic stroke
mod-vigorous exercise can reduce risk of ischemic stroke by 35%
what are guidelines for activity to reduce risk of ischemic stroek
- 150 min of mod intensity or 75 min of vigorous activity
- paired with strength 2x/wk
how does smoking influence stroke risk
current smokers have a 2-4x higher risk compared to quitters > 10 years
are ischemic strokes thrombolytic or embolic in nature?
trick question: they can be either
what can cause hemorrhagic strokes (4)
- uncontrolled HTN
- trauma
- AVM
- ruptured aneurysm
describe the area of a stroke as it relates to pathophysiology
core of irreversible cell damage surrounded by a penumbral area of potentially reversible damage
how does neuronal death occur, generally
focal lesion leading to destructive enzyme activation, increased metabolic demands, and edema
briefly comment on edema as it relates to strokes
it maxes out at 4 days but can persist up to 3 weeks creating concern with increased ICP
the NIHSS is done in the ER and on the floor, describe its scoring as it relates to severity
0 - no stroke 0-4 - minor stroke 5-15 - moderate stroke 16-20 moderate to severe stroke 21-42 severe stroke
complete the following sentence
each minute of large vessel ischemic stroke untreated, close to ________ neurons die
two million
how is ischemic CVA typically managed
recanalization via IV r-tPA or TNK within 3 hours of onset of symptoms or catheter embolectomy if patient arrives outside of r-tPA window
very important question
if a hemorrhagic CVA, how long after admission until we evaluate
patient must have a stable CT before initiating therapy
very important question
if an ischemic w/o r-tPA CVA, how long after admission until we evaluate
when the patient is stable usually 24-72 post
very important question
if an ischemic with r-tPA CVA, how long after admission until we evaluate
24 hours post completion of transfusion
when is stroke recovery fastest
within the first few weeks
when does the majority of neurologic recovery take place
first 3-6 months
