CVA - cerebrovascular accident - Stroke Flashcards
what is a CVA
acute, neurologic deficit d/t ischemia (loss of perfusion)
what are the two types of strokes
- hemorrhagic (aprox 20%) - due to rupture and hemorrhage
- Ischemic (aprox 80%) - due to occluded vessel caused by thrombus or embolus
Risk factors for stroke
same as MI
Patho of stroke in general
-brain must have 02 and glucose at all times, damage can occur in less than 5 minute -brain aerobic metabolism only, cannot do anaerobic metabolism
Transient ischemic attack (TIA)
- mini stroke
- brief reversible focal ischemia
- resolves before infarction
- no permanent damage
- increases risk of stroke
__________ is a very important warning sign for a stroke to happen soon
transient ischemic attack
Ischemic stroke
- vessel obstruction , Focal ischemia (loss of perfusion to brain)
- necrotic core (infarct)
- penumbra around core salvageable (loss of function structure still intact, penumbra minimally perfused if intervene salvageable)
- core enlarges if ischemia not corrected (causing more infarct)
Hemorrhagic stroke
- severed vessel
- hemorrhage
- brain compression (issues with increased intracranial pressure) (other issues losing substantial amount of blood, hypovolemia causing hypovolemic shock)
etiology of strokes
- mostly HTN and ageing
- aneurysms (can burst causing hemorrhage) & tumors (space occupying tumors can cause damage)
what are the mnfts of CVA
- acute onset
- unilateral weakness/numbness in face, arm & or leg
- altered speech (slurred)
- vision impaired (1 eye)
Mnfts of CVA depends on
site, vessel, collaterals (differentiate from collaterilzation
Treatment of a stroke
- life preservation
- salvage tissue ensure penumbra doesn’t become necrotic
- stat antiplatlet ts (IF NO hemorrhage) (prevents further clots)
- Tissue plasminogen activator (for breakdown of blood clots)
- risk factors (eg. statins which help lower blood cholesterol)
- surgery (if appropriate ex. carotidendectomy for stenosis and narrowing of carotid artery)
