CVA/AVM Flashcards
most common stroke in children
hemorrhagic stroke
who are at increased risk for pediatric stroke
boys and children of African-American descent
what are different types of stroke
arterial ischemic stroke, hemorrhagic stroke
clot that travels to the brain
embolus
clot that occurs in the brain
thrombus
narrowing or damaged arteries
arteriopathies
virus travels to cerebral arteries
post varicella arteriopathy
risk factors for arterial ischemic stroke
congenital heart disorder, sickle cell disease, head/neck trauma due to damage to blood vessels
abnormal shaped RBCs don’t travel through vessels typically and don’t carry oxygen correctly to the brain
sickle cell disease
focal deficits of arterial ischemic stroke and other signs
- Focal: acute hemiparesis, diploplia, dysarthria
- seizures, altered status, behavioral changes
management for arterial ischemic stroke
- anticoagulation medicine
- RTCs lacking use of tissue plasminogen activator (tPA) in children
- supplemental oxygen is hypoxemic
- hydration
- monitor for fevers/infectious causes
causes of hemorrhagic stroke
- rupture of blood vessel in brain
- rupture of malformed vessels (AVM)
- sickle cell
the risk of hemorrhage stroke is higher in individuals with
hemophilia (lack of blood clotting proteins)
signs/sx of hemorrhagic stroke
- altered mental status
- seizures
- nausea/vomiting
- older children: HA
- abrupt onset of sx with neurologic deterioration
management of hemorrhagic stroke
- ICP monitoring (external ventricular device)
- prevention of cerebral edema
- surgical management (hematoma evacuation)
- watching for signs of hydrocephalus
tangled mess of blood vessels in the brain or spine
arteriovenous malformation (AVM)
disruption of oxygenated blood to the brain - oxygenated blood in the arteries gets diverted to the veins, bypassing brain tissue
arteriovenous malformation
what may patients have with AVM even though most go un-diagnosed until rupture
history of HA or present with HA/seizures
etiology of AVM
considered congenital, males more affected than females
movement analysis used to assess isolated joint movement vs synergy patterns
Brunnstrom stages of recovery
no voluntary or reflex activity present
I - flaccidity
synergy pattern begins to develop, may appear as associated reactions
II - spasticity begins to develop
movement synergies can be performed voluntarily
III - spasticity reaches peak
deviation from movement synergy is possible, limited combo of movements
IV - spasticity begins to decrease
movement synergies less dominant, more complex movement possible
V - spasticity continues to reduce
isolated and combo movement evident, coordination may be impaired
VI - spasticity essentially absent
return to fine motor skills
VII - return to normal function
