CVA Intro & Clinical syndromes Flashcards
CVA: what is a stroke?
sudden loss of neurological function caused by an interruption of blood flow to the brain
What are the types of strokes(CVA)?
- Ischemic: occurs secondary to thrombosis, embolism, or hypoperfusion
& Affects 80% of individuals with stroke
- Hemorrhagic: occurs when blood vessels rupture, causing leakage of blood in or around the brain
What is the CVA course?
*Deficits of CVA must remain for at least 24 hours
location and early care management indicates impairment
Some spontaneous improvement may occur as swelling reduces (reversible ischemic neurological deficit)
Deficits may lead to lasting disability
What are stroke Classifications?
Etiological Categories:
Thrombosis
Embolus
Hemorrhage
Vascular Territory
ACA, MCA, PCA
Management Categories
TIA
Minor stroke
Major stroke
Deteriorating stroke
Young stroke
What are Epidemiology and Etiology of CVA
*5th leading cause of death
*Leading cause of long-term disability in the US
*Younger women have less risk, but older (85+) have an increased prevalence
*African Americans have twice the risk of first-stroke
*Stroke incidence increases with age
*Hemorrhagic strokes account for the largest number of deaths
What are some risk factors of CVA?
-Hypertension (HTN)
-Diabetes mellitus (DM)
-Disorders of heart rhythm
-High blood cholesterol and other lipids
-Smoking/Tabacco use
-Heart disease
What are modifiable risk factors?
Cigarette smoking
physical inactivity
obesity
diet
What are early warning signs of stroke?
B E F A S T
-Balance
-EYES
-FACE
-ARMS
-SPEECH
-TIME
what are ACA; anterior cerebral artery syndrome
*Contralateral hemiparesis (LE is more involved)
*Contralateral hemisensory loss (LE is more involved)
*Urinary incontinence
*Problems with imitation and bimanual tasks, apraxia
*Akinetic mutism, slowness, lack of spontaneity, motor inaction
*Contralateral grasp reflex, sucking reflex
Middle Cerebral Artery Syndrome
*Contralateral hemiparesis (UE and face is more involved)
*Contralateral hemisensory loss (UE and face is more involved)
*Motor speech impairment
*Receptive speech
impairment
*Global aphasia
*Perceptual deficits
*Limb-kinetic apraxia
*Contralateral homonymous hemianopsia
*Loss of conjugate gaze to the opposite side
*Sensory ataxia of contralateral limbs
What is APRAXIA?
*difficulty with planning and sequencing movements that cannot be accounted for by any other reason
-Ideational: inability of the patient to produce movement either on command or automatically and represents a complete breakdown in the conceptualization of the task
-Ideomotor: the patient is unable to produce a movement on command, but he or she is able to move automatically
*More evident with L hemisphere damage
What are examples of Aphasia detailed?
Brocas aphasia:
nonfluent aphasia, limited, vocabulary, slow and hesitant speech
Wernickes aphasia: impaired auditory comprehension, fluent speech, normal rate and melody
Global aphasia: nonfluent speech with poor comprehension
What is posterior Cerebral Artery Syndrome?
Peripheral Territory:
-Contralateral homonymous hemianopsia
-Bilateral homonymous hemianopsia with some degree of macular sparing
-Visual agnosia
-Prosopagnosia
-Dyslexia
-Memory deficit
-Topographic disorientation
Central Territory:
-Central poststroke (thalamic) pain syndrome
-Spontaneous pain and dysesthesias, sensory impairments
-Involuntary movements
-Contralateral hemiplegia
-Oculomotor nerve palsy
what is a Lacunar stroke?
*Caused by small vessel disease in the cerebral white matter
*Syndromes are consistent with specific anatomical sites
Syndromes can be motor, sensory, etc.
*Higher cortical areas are persevered so deficits in consciousness, language, or visual fields are not seen
what is Vertebrobasilar Artery Syndrome
*Occlusions of this system can produce a wide variety of symptoms with both ipsilateral and contralateral signs
-This occurs because some brainstem tracts will have crossed, and some will not have yet crossed
*Cerebellar and cranial nerve abnormalities are present
