CVA (Part 1) Flashcards
What is a Cerebrovascular Accident (CVA)?
A sudden loss of neurological function caused by interruption of the blood flow to the brain.
Define ischemic stroke.
Stroke caused by blockage of blood flow, accounting for 87% of all strokes.
Define hemorrhagic stroke.
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.
What are the types of ischemic strokes?
- thrombus
- embolus
- low systemic perfusion/hypoperfusion
Describe thrombotic strokes.
Caused by platelet adhesion and aggregation on plaques, leading to local occlusion of blood vessels.
What are the common sites for atherosclerotic plaque formation?
- origin of carotid arteries
- vertebral arteries
- junction of basilar and vertebral arteries
What are the major modifiable risk factors for CVA?
- hypertension
- diabetes
- cardiac arrhythmias
- high cholesterol
- CKD
- obesity
- tobacco use
- physical inactivity
- poor nutrition
What are the non-modifiable risk factors for CVA?
Family history, age, gender, and race/ethnicity.
What are the common symptoms of a stroke (FAST)?
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call emergency services
Compare and contrast the clinical findings of left vs. right hemisphere lesions.
- Left hemisphere lesions affect language and logical processing
- Right hemisphere lesions affect spatial and perceptual abilities.
What are the common imaging techniques used for CVA diagnosis?
- CT
- MRI
- MRA
- Doppler ultrasound
- What is tPA and when is it used?
- Why is tPA not appropriate for hemorrhagic strokes?
- Tissue plasminogen activator; a clot-busting drug used within a 3-hour window for ischemic stroke.
- Because it can exacerbate bleeding.
Define Transient Ischemic Attack (TIA).
Neurologic dysfunction from focal cerebral ischemia not associated with permanent cerebral infarction, typically lasting less than 24 hours.
Describe common CVA vascular syndromes.
- MCA syndrome
- ACA syndrome
- PCA syndrome
- vertebrobasilar artery syndromes
- each presenting with specific clinical findings
What are the outcomes for patients with ischemic vs. hemorrhagic strokes?
Outcomes can be similar, but hemorrhagic strokes have higher initial mortality.
What are common medications used in the management of CVA?
- anticoagulants
- antiplatelets
- antihypertensives
- statins
What is the definition of a CVA?
A cerebrovascular accident, or stroke, is a sudden loss of neurological function due to interruption of blood flow to the brain.
What is the most common cause of a thrombotic stroke?
Atherosclerosis of blood vessels.
What is the most commonly used imaging technique for diagnosing strokes?
Computed Tomography (CT).
What is the annual number of strokes in the US?
Approximately 795,000.
What is the leading cause of long-term disability among adults in the US?
Stroke (CVA).
What is the most significant modifiable risk factor for preventing subarachnoid hemorrhage?
Smoking cessation.
How does physical activity impact stroke risk in females?
Participation in any physical activity reduces stroke risk by 50%.
What dietary habit increases the risk of ischemic stroke?
Each 1 serving increase in sugar-sweetened soda.
What dietary habit reduces the risk of stroke?
Consuming 7 servings of fruits and vegetables per day.
What type of stroke accounts for 87% of all strokes?
Ischemic stroke.
What percentage of strokes are hemorrhagic?
13%.
What are the preferred sites for atherosclerotic plaque formation in thrombotic strokes?
- origin of carotid arteries
- vertebral arteries
- junction of basilar and vertebral arteries (pons)
What are the types of hemorrhagic strokes?
- Intracerebral hemorrhage (ICH)
- Subarachnoid hemorrhage (SAH).
What is the typical onset and cause of embolic strokes?
Sudden onset, typically caused by cardiac diseases such as MI, rheumatic heart disease, or bacterial endocarditis.
What is the significance of the ‘3-hour window’ in stroke treatment?
tPA is most effective within 3 hours of ischemic stroke onset.
What is the difference between a TIA and a stroke?
- TIA involves temporary neurological dysfunction without permanent damage
- Stroke causes permanent brain damage
How does high cholesterol contribute to stroke risk?
It leads to atherosclerosis, increasing the risk of thrombotic and embolic strokes.
What is the role of Doppler ultrasound in stroke diagnosis?
It assesses the vertebrobasilar system and carotid arteries for blood flow issues.
