CVI Flashcards
Risk factors for strokes?
Poorly or uncontrolled HTN
Smoking
Insulin resistance and diabetes mellitus
Polycythemia, thrombocythemia
High cholesterol or low HDL
Congestive hear disease & peripheral vascular disease
Hyperhomocysteinemia – high homocysteine level – amino acid produced when proteins are broken down
Atrial fibrillation
What Is a Ischemic Stroke?
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Obstruction of blood flow to the brain caused by a thrombus, embolus, or hypoperfusion –decreased blood volume or heart failure
Decreased blood flow causes ischemia and can cause infarction – death of tissue
S+S of ischemic stroke?
S&S – weakness, numbness, sudden confusion, loss of balance, or sudden severe headache –resolves within an hour
People who suffer an embolic stroke usually suffer?
a second stroke as the emboli still exists
Embolic stroke Vs Thrombotic Stroke
Embolic stroke – sudden onset – no history of claudication – may have cardiac abnormalities – comes from a embolus elsewhere in the body
Thrombotic – slow progression – history of claudication – generally no cardiac abnormalities – history of atherosclerosis
Signs and symptoms of of ischemic strokes?
dependent on the site of obstruction, damage done, extent of collateral circulation that develops
Example - Carotid – dysphagia
Generally Headache, confusion, dizziness, weakness or paralysis
Signs and symptoms of a hypo perfusion ischemic stroke?
Hypoperfusion ischemic stroke - Symptoms are bilateral and diffuse
FAST?
1.) Face - is it drooping
2.) Arms - can you raise both
3.) Speech - is it slurred or jumbled
4.) Time - to call 9-11 right away
What is a hypoperfusion stroke?
Systemic hypoperfusion caused by cardiac failure, pulmonary embolism or hemorrhage that results in inadequate blood flow to brain
-Going to pull out large sections of plaque from the carotid
What is an Embolic stroke?
Fragments that break from a thrombus formed outside the brain – heart, aorta, common carotid artery – can also be from fat, air, tumour, bacteria, foreign body – anything that is denser and causes a clog
Risk factors for an embolic stroke?
Clot coming from the heart and travels through to the brain - A fib
think about what can be happening in the heart – atrial fibrillation, potential for pooling of blood and then sending clot into cerebral circulation, left atrial or ventricle disease – blood flow is coming from the left ventricle, recent myocardial infarction, defects, tumours
Where do embolic stroke obstruct?
Usually small brain vessels – obstructs at a bifurcation
What is a thrombotic stroke?
Arterial occlusions caused by thrombi in arteries supplying brain or intracranial vessels
Risk factors for thrombotic strokes?
Risk factors – increased coagulation or inadequate cerebral perfusion
Outcome of a right sided stroke?
Left sided weakness or paralysis
Denial of paralysis – reduced insight into condition – “left neglect” – lack of response to stimuli on the left side
Visual – can’t see the left side
Depth perception
Recognition of body parts
Memory problems
Depression,
inappropriate behaviours,
Impulsivity
Outcome of left sided hemisphere stork damage?
right sided weakness or paralysis
Problems with speech – speaking and understanding
Visual – can’t see the right side of field of vision – both eyes
Depression & cautiousness
Impaired cognitive abilities
Memory problems
What is a migraine?
episodic neurologic disorder headache lasting 4-72 hours
Basically – we can have a migraine with an aura or a migraine without an aura – can be a visual, sensory, or motor aura
Signs and symptoms of a migraine?
Pain, nausea and visual changes are typical of a classic form
Cluster headache
Short term
one side
most painful
Tension headache?
Tight band around the head and both sides
Dehydration headache that is going on
Minor headaches
Can sometimes tell what brings them on
What are the 4 phases of a headache?
Premonitory phase – hours to days before onset of a headache – tiredness, irritability, inability to concentrate, and stiff neck
Migraine aura –may last 1 hour. Symptoms include visual (flashes of light), sensory (tingling on one side of body), or motor (inability to speak clearly)– only 1/3 of people report having an aura
Headache phase – throbbing and spreading to the entire head – accompanied by nausea, vomiting, fatigue, & dizziness – this is the stage that may last 4-72 hours
Recovery phase – irritability, fatigue, & depression – lasts hours to days
What are individuals who suffer from migraines are at a higher risk of?
Individuals who suffer from migraines are at higher risk of epilepsy, depression, anxiety, cardiovascular disease, & stroke
What is meningitis?
Inflammation of the meninges of the brain or spinal cord
What is a TIA - transient ischemic attacks
Focal cerebral ischemia
S&S – weakness, numbness, sudden confusion, loss of balance, or sudden severe headache –resolves within an hour
If MRI scan reveals infarction – can be sign of upcoming stroke – within 90 days
