MDT Cerebral Vascular Accident (CVA) and Transient Ischemic Attack (TIA). Flashcards
Blood Supply of the Brain what 3 types vessels?
(1) Internal Carotid Arteries
(2) Vertebral - Basilar Arteries
(3) Circle of Willis
What Supplies the majority of the ipsilateral cerebral hemisphere
Internal Carotid Arteries
Two major branches of internal carotid arteries
1) Anterior cerebral artery (ACA)
2) Middle cerebral artery (MCA)
What supplies the Cerebellum and Brainstem
Vertebral - Basilar Arteries
What Interconnects the Internal Carotid and Vertebral Basilar Arteries
Circle of Willis
The _______ is the acute neurologic injury that occurs as the result of the interrupted
blood flow to the brain
“stroke”
What type of stroke?
Rupture of a blood vessel causing bleeding into the brain and lack of cerebral blood flow leading to ischemia
Hemorrhagic stroke
What type of stroke?
Blockage of a blood vessel causing lack of cerebral blood flow leading to ischemia
Ischemic stroke
What TIA and CVA are subtypes of what type of stroke?
Ischemic stroke
80% of strokes are_____, 20% are ______
80% of strokes are ischemic, 20% are hemorrhagic
Ischemic strokes can convert to hemorrhagic if ______
given enough time
Can or Can not: distinguish between the two types of stroke based on clinical criteria
can not
The treatment for one type of stroke would be ______ if given for the other
catastrophic
Risk factors for stroke are
Risk factors are HTN, atherosclerosis and age
Pathophysiology of what type?
Poor blood flow to the brain that can lead to cell death and tissue necrosis
Ischemic Stroke
Ischemic Stroke
Obstruction of an artery due to a blockage that forms in the vessel
Often due to atherosclerosis
Thrombotic
Ischemic Stroke
Obstruction of an artery due to a blockage from debris that has broken off from a distal area
Embolic
Ischemic Stroke
Lack of brain blood flow to decreased systemic blood flow
Systemic hypoperfusion
_______ is defined as a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.
Transient ischemic attack
________ or stroke is defined as neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia with infarction (tissue death) of central nervous system tissue.
Cerebral Vascular Accident (CVA)
The only way to determine the difference between CVA and TIA is by ______
MRI
True/False
You don’t have to treat both TIA and CVA the same
False
treat them the same, TIA has a high risk of becoming a CVA with infarction.
TIA vs CVA
No acute infarction
TIA
Stroke Clinical Manifestations
“FASTER” Mneumonic
-Face drooping or numbness on one side of the face
-Arms – one limb being weaker or more numb than the other
-Stability – steadiness on feet
-Talking – slurring, garbled, nonsensical words, inability to respond
normally
-Eyes – visual changes
-React – MEDEVAC immediately and note time of symptom onset
Risk factors for what type of stroke?
(a) History of vascular disease
(b) Atrial fibrillation (not on meds)
(c) Atrial septal defect (ASD)
(d) Ventricular septal defect (VSD) with deep vein thrombosis (DVT)
(e) Recent myocardial infarction
(f) Atherosclerosis
(g) Clotting disorders
Ischemic stroke
Two subtypes of hemorrhagic strokes
1) Intracerebral hemorrhage
2) Subarachnoid hemorrhage
What subtype of hemorrhagic stroke?
bleeds directly into the brain tissue
Intracerebral hemorrhage
What type of hemorrhagic stroke?
bleeds into the subarachnoid space
Subarachnoid hemorrhage
Clinical manifestations of what?
(a) Depends on the site of bleed
(b) Intracerebral hemorrhage usually has gradual onset as blood builds
(c) SAH has maximal impact right away usually with intense “worse headache of my life” headache
(d) Headache, vomiting, decreased level of consciousness occurs in about half the patients
(e) Symptoms tend to worsen gradually overtime
Hemorrhagic Strokes or Intracranial Hemorrhage (ICH)
Risk factors for what type? (a) Hypertension (b) Trauma (c) Bleeding disorders (d) Drug use (cocaine, methamphetamine) (e) Vascular malformations(aneurysms) 1) Aneurysms are outpouchings and ballooning of artery due to weakness in the vascular wall
Hemorrhagic Strokes or Intracranial Hemorrhage (ICH)
What helps to differentiate between ischemic and hemorrhagic stroke?
Imaging
what type of Imaging is used to differentiate types of stroke
- Non-contrast CT
- MRI
