URR Signs and Symptoms of Cerebrovascular Disease Flashcards
most common type of stroke?
ischemic attack
-ICA stenosis presents highest risk of TIA/stoke
strongest risk factor for stroke?
HTN
mechanisms of stoke?
-ischemic stroke
-HTN
-dissection
-vasospasm
-intracranial hemorrhage
-embolization of atherosclerotic material
-polycythemia vera
thickening of blood reduces blood flow and may lead to ischemia distally
polycythemia vera
1 cause of vascular disease?
atherosclerosis formation
most common cerebrovascular site for atherosclerosis formation?
CCA bif
-2nd: origin of CCA
> 1.2 mm of atherosclerosis indicates increase in concern for what?
stenosis
modifiable risk factors for stroke?
-hypertension
-diabetes
-hyperlipidemia
-smoking
-inactivity
-obesity
-poor nutrition
non modifiable risk factors for stoke?
-gender: more common in males, but women die from more
-age
-fam hx
insufficient blood supply to brain due to stenosis?
brain infarction
difference between TIA and CVA?
TIA: symptoms last < 24 hours
CVA: symptoms/ damages last > 24 hours
rupture of intracranial vessels?
subarachnoid hemorrhage
hemispheric symptoms?
related to right and left brain with loss of functionality
-example: right brain controls left side of body -RICA stenosis -> left paresis (same for left side)
blood pressure in the arms should not differ more than how much?
20 mmHg
-or subclavian stenosis is suspected in the area with decreased pressures
nonspecific symptoms?
-bruit
-headache
-syncope
-dysarthmia
-dizziness
noise hear with stethoscope caused by turbulent flow
bruit
bilat bruit heard prox can indicate what?
ao valve stenosis
bruit hear during systole and diastole usually indicates what?
significant stenosis
tingling of skin?
paresthesia
weakness?
hemiparesis
can understand others but cant speak
broca aphasia (expressive aphasia)
cholesterol emboli that lodge in retinal artery?
hollenhorst plaque
homonymous hemianopia
visual defect in half the eye
temp partial with or without total monocular blindness
amaurosis fugax
-caused by ipsilat stenosis of the ICA and or opthalmic Artery
ICA disease symptoms?
-unilat symptoms with contralat side stenosis
-paresthesia
-hemiparesis
-paralysis
-broca aphasia
-hollenhorst plaque
-homonympus hemianopia
-amaurosis fugax
unable to understand speech, speak, or follow directions
Wernicke aphasia (receptive aphasia)
MCA disease symptoms?
-wernicke aphasia
-dysphasia
-behavioral changes
-severe hemiparesis in contralateral face/arms
ACA disease symptoms?
-loss of coordination
-incontinence
-severe leg hemiparesis or hemiplegia
-facial drooping/asymmetry
PCA disease symptoms?
-dyslexia
-coma
vertebral/basilar disease symptoms?
-vertigo
-fainting
-ataxia
-bilat blurred vission
-bilat homonymous hemaniopia
-bilat paresthesia
-drop attack
-dysphagia
diplopia
bilat blurred vision
homonymous hemaniopia
med or lat half of FOV disrupted
lack of corrdination
ataxia
trouble swallowing
dysphagia
IMT
intimal media thickening
-normal values range .4-1.0 mm
-values normally increase with age
more stiff or calcified vessel does what to resistance?
higher
less muscle tone does what to blood flow?
decrease
more branches does what to resistance?
decrease
extrems, muscles, and pre prandial organs do what to blood flow resistance?
high
liver, kidney, and brain blood flow have what kind of resistance?
low
CCA doppler?
combo of ICA and ECA flow; higher resistance flow than ICA and more diastolic flow to the ECA; normal flow demonstrates PSV <125 cm/sec EDV <40 cm/sec
doppler of ECA?
high resistance normal flow <150 cm/sec
ICA doppler?
low resistance
PSV < 125 cm/sec EDV 40cm/sec
temporal tap differentiates the ECA from what?
ICA
-press index finger against patients temple
-ICA will show no response in most patients
the vertebral arteries originate form where ?
subclavian bilat
the vertebral arteries travel through the vertebral bodies to merge inside the cranium to form the what?
basilar artery
to locate the vertebral arteries find the CCA and angle where?
posterior
the vertebral artery should demonstrate antegrade flow toward what?
the brain
-should be monophasic with mild diastolic flow
