Stroke Flashcards
what factors can contribute to the increased risk of stroke
HTN
hypercholesterolemia
CAD
diabetes
obesity
smoking
alcohol
what ethnicity is double at risk for first stroke
african americans
what is the most common type of stroke
ischemic (87%)
what type of stroke accounts for 38% mortality rates in the first month
hemorrhagic
34% of hospitalization due to stroke are patients how old
< 65
what are the warning signs of stroke
BE FAST
balance - steady on feet
eyes - loss vision in one/both eyes
face
arms
speech
time
describe S/S of anterior cerebral A stroke (ACA) and correlate to areas of damage
- contralateral hemiparesis leg > arm (primary motor area)
- contralateral hemisensory loss leg > arm (primary sensory area)
- difficulty with imitation, bimanual tasks, apraxia (corpus callosum)
- slowness, delay of spontaneity, motor inaction (unknown)
desrice S/S of middle cerebral A stroke (MCA) and correlate to areas of damage
- contralateral hemiparesis arm/face > leg (primary motor cortex/internal capsule)
- contralateral hemisensory loss UE/face > leg (primary sensory cortex)
- motor speech impairment (expressive/broca’s) if L hemisphere (Broca’s)
- receptive speech impairment if L hemisphere (Wernicke’s)
- U/L neglect if R hemisphere (parietal sensory association cortex)
describe s/s posterior cerebral artery stroke (PCA) and correlate to areas of damage
- contralateral homonymous hemianopsia (primary visual cortex)
- B/L homonymous hemianopsia
- visual agnosia (L occipital lobe)
- central post-stroke (thalamic) pain (ventral posterolateral nucleus of thalamus)
- Weber’s syndrome - ipsilateral occulomotor N palsy/contralateral hemiplegia (CN 3/cerebral peduncle of midbrain)
describe s/s of vertebrobasilar A stroke (VB) and correlate to areas of damage
- locked in syndrome (tetraplegia/CN5-7 involved, vertical gaze spared, A&O but cannot move/speak (ventral pons))
- Wallenberg’s syndrome
- Horner’s syndrome
R hemisphere stroke behaviors s/s
- difficulty with spatial perceptual tasks - cannot see big pictures
- quick, impulsive
- overestimate ability, unaware of deficits
- poor safety judgment
- requires lots of feedback, must slow down activity, keep environment free of distractions
- difficulty with expression of negative emotions
L hemisphere stroke behaviors s/s
- difficulty communicating
- won’t be able to process information in a linear manner
- cautious, anxious
- disorganized
- hesitant to try new tasks, needs more external feedback
- aware of deficits
- difficulty with expression of positive emotions
- highly distractible
- perseveration
list associated conditions after a stroke
- altered consciousness (normal, lethargy, obtundation, stupor, coma)
- aphasia/dysphagia (aspiration)
- cognitive dysfunction (memory, execuative functions, vascular dementia, delirium)
- altered emotional status
- perceptual deficits (visual-perceptual deficits 32-41% of all patients with stroke)
- seizures
- b/b issues
- CV and pulmonary dysfunction
- DVT/PE
- osteoporosis and fx risk
