Stroke Flashcards
What is a stroke?
- An acute, rapidly-developing focal neurological dysfunction due to an abnormal perfusion
- Interruption of the normal blood supply to the brain (ischemia), resulting in neuro dysfunction and the death of brain cells
What are the two emphases and the de-emphasis of the AHA/ASA definition of stroke?
- Imaging
- Neurological deficits
De-emphasis of temporal aspects, like sx lasting for greater than 24 hours
What types of infarctions does the definition of stroke include?
- Cerebral infarctions
- Spinal infarctions
- Retinal infarctions
Clinically, stroke continues to be used to refer to cerebral infarctions
What is the most common type of stroke?
Ischemic stroke, about 87% of all strokes
What is an ischemic stroke?
A stroke due to thrombosis, embolism, or systemic hypoperfusion
Where is the most common site of an ischemic stroke?
Middle cerebral artery (MCA)
What is an important warning signs of a stroke?
Transient ischemic attacks (TIA)
What are some cardioembolic causes of ischemic stroke?
***AFIB*** Ventricular thrombus Prosthetic valves Rheumatic heart disease Other cardiac sources
What is the second most common type of stroke?
Intracerebral hemorrhage (ICH), about 10% of all strokes
What is an intracerebral hemorrhage?
Bleeding inside the brain
What is the third most common type of stroke?
Subarachnoid hemorrhage (SAH), about 3% of all strokes
What is a subarachnoid hemorrhage?
Bleeding in the subarachnoid space
Stroke is the what # leading cause of death in the United States?
Fifth leading cause of death
What is the leading cause of disability?
Stroke
Who has a higher lifetime incident of stroke: females or males?
Females
Of younger people, who is more likely to have a stroke: a female or male?
Male
What is a major risk factor for stroke?
Age, particularly 75 and older
Who is more likely to die from a stroke?
Non-Hispanic black Americans and those living in the southern state “stroke belt”
What is the cause of the decline in stroke deaths?
A decrease in both stroke incidents and stroke mortality
- Improved blood pressure control
- Reduced smoking
- Improved diabetes control
- Improved lipid control
What are the different clauses of the stroke?
- Thrombus
- Embolus
- Small vessel disease
- Hypoperfusion
- Hyper viscous blood
- Cryptogenic
Where and how does a thrombus occur?
- Within cerebral vasculature
- Usually starts when atherosclerotic plaque becomes unstable, similar to MI
What causes an embolus formation, and where are these typically found when someone has a stroke?
- Usually of cardiac or carotid origin
- Atrial fibrillation
- Large cerebral artery occlusion is typically embolic
- Valvular thrombi: mitral stenosis, endocarditis, or prosthetic valve
What kinds of infarcts are associated with small vessel disease?
Lacunar Infarcts
What are some causes of cerebral hypoperfusion?
Low blood pressure
Decreased cerebral perfusion pressure