CVA (Part 1)

Question 1

What is a Cerebrovascular Accident (CVA)?

Answer 1

A sudden loss of neurological function caused by interruption of the blood flow to the brain.

Question 2

Define ischemic stroke.

Answer 2

Stroke caused by blockage of blood flow, accounting for 87% of all strokes.

Question 3

Define hemorrhagic stroke.

Answer 3

Stroke caused by rupture of blood vessels, leading to bleeding in or around the brain, accounting for 13% of all strokes.

Hemorrhagic Strokes: Involves bleeding into brain tissue after rupture of a blood vessel wall, causing edema and compression of brain tissue.

Question 4

What are the types of ischemic strokes?

Answer 4

• thrombus
• embolus
• low systemic perfusion/hypoperfusion

Question 5

Describe thrombotic strokes.

Answer 5

Caused by platelet adhesion and aggregation on plaques, leading to local occlusion of blood vessels.

Question 6

What are the common sites for atherosclerotic plaque formation?

Answer 6

• origin of carotid arteries
• vertebral arteries
• junction of basilar and vertebral arteries

Question 7

What are the major modifiable risk factors for CVA?

Answer 7

• hypertension
• diabetes
• cardiac arrhythmias
• high cholesterol
• CKD
• obesity
• tobacco use
• physical inactivity
• poor nutrition

Question 8

What are the non-modifiable risk factors for CVA?

Answer 8

Family history, age, gender, and race/ethnicity.

Question 9

What are the common symptoms of a stroke (FAST)?

Answer 9

• Face drooping
• Arm weakness
• Speech difficulty
• Time to call emergency services

Question 10

Compare and contrast the clinical findings of left vs. right hemisphere lesions.

Answer 10

• Left hemisphere lesions affect language and logical processing
• Right hemisphere lesions affect spatial and perceptual abilities.

Question 11

What are the common imaging techniques used for CVA diagnosis?

Answer 11

• CT
• MRI
• MRA
• Doppler ultrasound

Question 12

• What is tPA and when is it used?
• Why is tPA not appropriate for hemorrhagic strokes?

Answer 12

• Tissue plasminogen activator; a clot-busting drug used within a 3-hour window for ischemic stroke.
• Because it can exacerbate bleeding.

Question 13

Define Transient Ischemic Attack (TIA).

Answer 13

Neurologic dysfunction from focal cerebral ischemia not associated with permanent cerebral infarction, typically lasting less than 24 hours.

Question 14

Describe common CVA vascular syndromes.

Answer 14

• MCA syndrome
• ACA syndrome
• PCA syndrome
• vertebrobasilar artery syndromes

• each presenting with specific clinical findings

Question 15

What are the outcomes for patients with ischemic vs. hemorrhagic strokes?

Answer 15

Outcomes can be similar, but hemorrhagic strokes have higher initial mortality.

Question 16

What are common medications used in the management of CVA?

Answer 16

• anticoagulants
• antiplatelets
• antihypertensives
• statins

Question 17

What is the definition of a CVA?

Answer 17

A cerebrovascular accident, or stroke, is a sudden loss of neurological function due to interruption of blood flow to the brain.

Question 18

What is the most common cause of a thrombotic stroke?

Answer 18

Atherosclerosis of blood vessels.

Question 19

What is the most commonly used imaging technique for diagnosing strokes?

Answer 19

Computed Tomography (CT).

Question 20

What is the annual number of strokes in the US?

Answer 20

Approximately 795,000.

Question 21

What is the leading cause of long-term disability among adults in the US?

Answer 21

Stroke (CVA).

Question 22

What is the most significant modifiable risk factor for preventing subarachnoid hemorrhage?

Answer 22

Smoking cessation.

Question 23

How does physical activity impact stroke risk in females?

Answer 23

Participation in any physical activity reduces stroke risk by 50%.

Question 24

What dietary habit increases the risk of ischemic stroke?

Answer 24

Each 1 serving increase in sugar-sweetened soda.

Question 25

What dietary habit reduces the risk of stroke?

Answer 25

Consuming 7 servings of fruits and vegetables per day.

Question 26

What type of stroke accounts for 87% of all strokes?

Answer 26

Ischemic stroke.

Question 27

What percentage of strokes are hemorrhagic?

Answer 27

13%.

Question 28

What are the preferred sites for atherosclerotic plaque formation in thrombotic strokes?

Answer 28

• origin of carotid arteries
• vertebral arteries
• junction of basilar and vertebral arteries (pons)

Question 29

What are the types of hemorrhagic strokes?

Answer 29

• Intracerebral hemorrhage (ICH)
• Subarachnoid hemorrhage (SAH).

Question 30

What is the typical onset and cause of embolic strokes?

Answer 30

Sudden onset, typically caused by cardiac diseases such as MI, rheumatic heart disease, or bacterial endocarditis.

Question 31

What is the significance of the ‘3-hour window’ in stroke treatment?

Answer 31

tPA is most effective within 3 hours of ischemic stroke onset.

Question 32

What is the difference between a TIA and a stroke?

Answer 32

• TIA involves temporary neurological dysfunction without permanent damage
• Stroke causes permanent brain damage

Question 33

How does high cholesterol contribute to stroke risk?

Answer 33

It leads to atherosclerosis, increasing the risk of thrombotic and embolic strokes.

Question 34

What is the role of Doppler ultrasound in stroke diagnosis?

Answer 34

It assesses the vertebrobasilar system and carotid arteries for blood flow issues.