Lecture 1 - CVA Epidemiology Flashcards
What are the 2 arteries that ascend the anterior and posterior aspect of the neck… and what loop do is formed in the brain from the this merging arterial supply
Anterior Blood Supply = carotid
Posterior Blood Supply= vertebral
Loop = Circle of Willis
Describe the anterior blood supply system
The left (arises from aortic arch) and right (arises from right subclavian artery) common carotid artery bifurcates at the level of the jaw (C3/C4) into the internal carotid artery (supplies the brain) and external carotid artery (supplies the face, scalp, skull, and meninges)
NOTE: Carotid pulse is felt just below jaw line
Describe the posterior blood supply system
The left and right vertebral arteries (arise from subclavian arteries) ascend in the neck through lateral foramina of the cervical vertebrae (enter at C6, exit at C1) and enter skull through foramen magnum. The left and right vertebral arteries merge on the anterior surface of the brainstem forming the basilar artery
What is the purpose of the circle of willis
Creates redundancy and collateral circulation
Describe the arteries that make up the circle of willis and where it can be found
Located on ventral surface of brain
What is the function of the posterior cerebral artery
Supplies blood the the posterior aspects of the brain
What is the function of the anterior cerebral artery
Provides blood supply to the anterior aspect of the brain which comprises of the cerebral hemispheres
What is the function of the middle cerebral artery
Supplies blood to the middle and lateral aspects of the brain and also to the cerebral hemispheres
What is a stroke
What are the warning signs of a stroke?
What is the age/sex distribution of stroke in canada
Chances of stroke increases as we get older. Mainly males from 50-85 and then above 85 it is primarily females because females live longer
Can strokes occur in children and what is a primary cause
Yes, 20% of causes in full term babies is due to congenital heart disease
Can strokes happen in young adults and what are the primary causes
Yes
What are risk factors for a stroke (modifiable, non-modifiable and condition risk factors)
What is the outcome profile of those who have a stroke
What are the 2 types of strokes?
- Hemorrhagic
- Ischemic
What 4 factors influence the severity and symptoms of a stroke?
What is the penumbra
Area of a tissue that is outside of the ischemic core that is affected by a stroke
What are the causes of an ischemic stroke?
Describe thrombotic strokes
Describe embolic strokes
What are 2 treatments for ischemic strokes
What does tPA (tissue plasminogen activator) do to treat ischemic strokes
How does an endovascular procedure treat ischemic strokes?
Transient ischemic attack (TIA)
What is the treatment for a transient ischemic attack
What are 4 types of brain hemorrhages that lead to hemorrhagic strokes
What is an intra-cerebral hemorrhage, its symptoms, causes and management
What is a subarachnoid hemorrhage, its causes and symptoms
What are 2 types of aneurisms and describe them
What are 2 treatments for aneurysms
What is the prognosis of hemorrhagic vs ischemic stroke recovery
Where do people get discharged after acute care admission for a stroke
What are the 4 processes of stroke recovery?
What is the average recovery profile for minor, moderate and major strokes
-Plateau at 3 months for minor and moderate strokes
-Major stroke hasn’t reached plateau even at 6 months
What does this figure mean in terms of walking speeds after stroke recovery?
Lots of variability for recovery of walking speed post-stroke = no clear path recovery is variable
What does this figure mean in terms of neurological recovery after a stroke?
-People with minor stroke will recover/max out at about 9 weeks
-The more severe the stroke the longer it will take to max out recovery of neurological capacity post-stroke
What does this figure mean in terms of functional recovery post-stroke?
-Functional recovery maxes out 2-3 weeks after their neurological recovery maxes out -> neurological recovery comes first and is more important
What are factors that influence ischemic stroke recovery
What are factors that influence hemorrhagic stroke recovery
What is the purpose of the CSMA
What are 3 key points to recovery of motor function following a stroke
