CVA/SAH Flashcards
ischemia stroke
inadequate blood flow to a part of the brain
hemorrhagic stroke
bleed into the brain leading to death of brain cells
stroke
- CVA or brain attack
- area of the brain affected will determine what functions are lost or impaired
- leading cause of long term disability in the US
common long term disabilities
- hemiparesis
- inability to walk
- complete or partial dependence for ADLs
- aphasia
- depression
internal carotid artery
supplies anterior part of brain
- frontal, parietal, and temporal lobes
- basal ganglia
- part of diencephalon
vertebral artery
supplies posterior part of brain
- temporal and occipital lobes
- cerebellum
- brainstem
- diencephalon
cerebral requirements
- continuous supply of O2 and glucose
- blood flow 750-1000mL/min or 20% of CO
mechanisms to maintain blood flow
- cerebral autoregulation
- potent vasodilators: increased CO2, Low PaO2
- systemic BP, CO, blood viscosity
- collateral circulation
cerebral autoregulation
changes in diameter of cerebral blood vessels so that the blood flow stay constant
things that can slow blood flow
- increased ICP
- atherosclerosis
conditions associated with stroke
- atrial fibrillation
- cardiac valve abnormalities
- DM
TIA
- temporary focal loss of neurologic function
- affects
- focal brain injury
- spinal cord
- retinal ischemia
- s/s usually last less than an hour
- no infarction
- may be d/t emboli
- precursor to worsening CVD
types of stroke
- ischemic: thrombotic, embolic
- hemorrhagic: intracerebral, subarachnoid
thrombotic stroke
- injury to vessel wall, blood clot forms
- develops where atherosclerotic plaques are developed
- infarction if there is occlusion
- mostly associate with HTN and DM
last stage of ischemic cascade
cell death/apoptosis
embolic stroke
- embolus travels and lodges and occludes a cerebral artery
- results in infarction and edema
- usually from heart conditions
- solid (fat), liquid (amniotic fluid), gas (air)
- occurs rapidly, no time for collateral circulation
- recurrence is common
intracerebral stroke
- bleeding in brain d/t rupture of a vessel
- sudden onset of s/s
- poor prognosis
subarachnoid stroke
- bleeding between the arachnoid mater and pia mater
- usually from genetics, trauma, cocaine
- “worst HA of my life”
- complications: rebleed, vasospasm
R brain damage
- L side hemiplegia
- L sided neglect
- spatial perceptual deficits
- tends to deny of minimize problems
- rapid performance, short attention span
- impulsive, safety issues
- impaired judgment
- impaired time concepts
L brain damage
- R side hemiplegia
- impaired speech/language
- impaired R/L discrimination
- slow performance
- aware of deficits: depression, anxiety
- impaired comprehension r/t language, math
motor functions s/s of stroke
- akinesia
- alterations in muscle tone and reflexes
- impairment of integration of movements
- initial period of flaccidity, following spasticity
communication s/s of stroke
- dysphasia/aphasia
- dysarthria: disturbance in muscular control of speech
- impairments in pronunciation, articulation, phonation
nonfluent aphasia
minimal speech activity with slow speech
fluent aphasia
-speech is present but contains little meaningful communication
receptive aphasia
loss of comprehension
expressive aphasia
loss of production of language
affect s/s of stroke
- difficulty controlling emotions
- emotions may be exaggerated or unpredictable
intellectual function s/s of stroke
-impaired memory and judgment
spatial-perceptual alterations s/s of stroke
- R sided stroke
- incorrect perception of self and illness
- agnosia
- apraxia
agnosia
inability to recognize objects by sight, touch, or hearing
apraxia
inability to carry out learned sequential tasks
elimination s/s of stroke
- urinary & bowel incontinence are temporary
- when stroke affects one hemisphere of brain, prognosis is excellent
gold standard for diagnosing stroke
non-contrast CT
