neuromuscular cht 60, 62, 63,64

Question 1

a sudden loss of function resulting from disruption of the blood supply to a part of the brain.

Answer 1

An ischemic stroke, formerly referred to as a cerebrovascular accident or “brain attack,”

Question 2

what are the 2 types of strokes

Answer 2

Hemorrhagic and Ischemic

Question 3

this stroke is due to an occlusion in the artery. occurs when a blood clot, or thrombus, forms in an artery that supplies blood to the brain slide 58

Answer 3

thrombotic stroke. Risk factors – same as for thrombus formation in other vessels as well as:
Oral contraceptive use
Dehydration
Sickle cell disease
Chronic hypoxia

Question 4

hemorrhagic stroke

Answer 4

when blood vessel in the brain burst and cause bleeding, therefore increase ICP and decrease perfusion. slide 61

Question 5

Subarachnoid hemorrhage

Answer 5

Subarachnoid hemorrhage causes neurological and systemic complications (ischemic stroke, cerebral edema, pulmonary edema, and myocardial ischemia

Question 6

Ischemic Stroke

Answer 6

An ischemic stroke is a type of stroke that occurs when a blood vessel that supplies the brain with oxygen and nutrients becomes blocked, which can damage the brain. Thrombotic strokes are a subtype of ischemic stroke that occur when a blood clot, or thrombus, blocks an artery that supplies blood to the brain

Question 7

Ischemic Stroke Comparison of left and right hemisphere [s73]

Answer 7

Left sided hemisphere stroke- paralysis or weakness on right side, right visual field deficit, aphasia, slow, cautious behavior, altered intelectual ability

Right sided hemisphere stroke- paralysis or weakness on left side, left visual field deficit, increased distractibility, impulsive behaviour and poor judgment, lack of awareness of deficits

Question 8

how to manage ichemic stroke

Answer 8

thrombolytic agents
t-PA: used to treat ischemic strokes by dissolving the blood clot that is blocking blood flow to the brain (based on patient’s weight). must be given within three hours, anti coagulant administration such as heparin, Lovenox, pradaxa, Xarelto).
3. antiplatelets (ASA, Plavix (clopidogrel)

Question 9

who is eligible for thrombolytic therapy [s78]

Answer 9

Eligibility Criteria for t-PA:
> 18 years or older
Time of onset of stroke is known and < 3 hours
Not taking warfarin (Coumadin) [because it is the antagonist for t-PA, reverses the effect]
No recent intracranial pathology (i.e. head injury, trauma)

Question 10

pathophysiology of Transient Ischemic Attack

Answer 10

a temporary decrease in blood flow to a specific region to the brain [s82]

Question 11

Transient Ischemic Attack signs

Answer 11

fleeting blindness (amaurosis fugax) that occurs without any warning, vertigo, diplopia, changes in level of consciousness, numbness, weakness

Question 12

Transient Ischemic Attack Medical management

Answer 12

anti-platelets: ASA, persantine, ticlid initially coumadin
2. treatment of hypertension
3.treatment of hyperglycemia
4. cessation of smoking
Surgical:
1. Carotid endarterectomy
2. Angioplasty