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Clinical Neuroscience > Week 7 Stroke > Flashcards

Week 7 Stroke Flashcards

1
Q

what are two ways we can get a stroke (CVA)

A

hemorrhage, or a broken vessel or a blockage and then a burst.

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2
Q

how often do people have strokes, and how often does someone die of a stroke

A

40 seconds, dies every 4 minutes

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3
Q

how many people have new and recurrent strokes every year

A

first: 610,000
recurrent: 185,000

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4
Q

how has more strokes at younger ages

A

men

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5
Q

in total, do men or women have more strokes per year

A

women

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6
Q

T/F: almost 2x risk of first stroke every in africans vs whites.

A

true

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7
Q

stroke is the ___ or ____ leading cause of death, according to different sources

A

5th or 3rd

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8
Q

every ___ minutes, some one dies from a stroke

A

3-4 minutes

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9
Q

what is the estimated indirect or direct cost of stroke

A

36.5 billion

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10
Q

what is he stroke belt

A

down like in the Bible Belt

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11
Q

25% of people age ___ and younger have a stroke

A

55y/o

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12
Q

only ___% of people under 40 have a stroke

A

5%

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13
Q

are the rate of hospitalization, rate of strokes in younger people and rates of stroke in white and blacks increasing

A

yes to all, all of these rates are increasing

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14
Q

why do we care that the age of stroke is getting younger

A

people are living longer with disability.

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15
Q

what is the leading risk factor for stroke

A

HTN is the leading

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16
Q

what are other risk factors for stroke

A

DM, heart rhythm things (A-fib increases risk stroke 5 fold, and is undetected), high cholesterol, smoking, tobacco use, physical inactivity, nutrition, family history and genetics, and chronic kidney disease.

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17
Q

are the risk factors modifiable or non modifiable. Why does this help us

A

they are modifiable, so we can do something to try and prevent stroke, or decrease the risk of a recurring stroke.

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18
Q

what are the signs and symptoms of stroke

A
  • sudden numbness and weakness (faces, arm and leg)
  • sudden confusion or difficulty speaking or understanding others
  • sudden difficulty with vision
  • sudden dizzy, difficulty walking, loss balance and coordination
  • sudden severe HA (worst ever)
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19
Q

what does FAST mean, and what do we use it for

A 
to spot a stroke 
face dropping 
arm weakness 
speech difficulty
time to call
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20
Q

can we educate patients using the FAST method

A

yes, educate them, and inform them that if they get these S and S to call 911 immediately

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21
Q

what is a stroke

A

damage to the brain from ischemic or hemorrhagic loss

22
Q

what is the primary pathology of a stroke

A

reduced arterial blood flow, cell death due to ischemia

23
Q

what is the secondary pathology of a stroke

A

cell death, edema, increased ICP, more cell death

edema can lead to herniation

24
Q

if symptoms last more than 24 hours what is it considered. less then 24 hours

A

more: CVA (Cerebrovascular accident)
less: TIA (transient ischemic attack)

25
Q

how much of the normal CO goes to the brain

A

17-20%

26
Q

what happens to blood flow in the brain with changes in the BP

A

increase BP, stretch the arterial wall, then it contracts, decreases flow and decreases BP in the brain

27
Q

what is normal cerebral blood flow

A

autoregulation, do chemical regulation, O2 vs CO2, pH, viscosity and ICP, and changes in BP

28
Q

if you increase ICP, what happens to blood flow

A

you decrease blood flow

29
Q

if autoregulation is disrupted, what are some S and S

A

dizziness and other signs

30
Q

what do we respond to more, changes in O2 or CO2

A

CO2

31
Q

what two things fall under the ischemic stroke category. what percent of strokes are these ischemic ones

A

87%

cerebral thrombus and cerebral embolus

32
Q

hemorrhage accounts for 13% of strokes. There are two types of these, what are they

A 
inter cranial (10%)
subarachnoid (3%)
33
Q

a clot (Cerebral thrombus) leads to occlusion which leads to…

A

hypoxia, ischemia, infarction and tissue death

34
Q

what is a transient ischemic attack (TIA)

A

deficit lasting less than 24 hours

35
Q

what % of strokes are preceded by TIA

A

15%

36
Q

what is the medial management of the cerebral thrombus

A

increased circulation, HOB down, normalize BP and thrombolytics

37
Q

what do thrombolytics do

A

destroy the clot, while having a TIA

38
Q

what must you manage with a cerebral thrombus

A

cerebral edema

39
Q

what are common sites for plaque build up and a thrombus

A

at bifurcations, like the carotid, brachiocephalic trunk, internal cerebral arteries and vertebral arteries

40
Q

what is a cerebral embolus

A

a traveling blockage, like thrombus, fat, air or bacteria that will cork the vessel

41
Q

what is the medical management of the cerebral embolus

A

anticoagulants and DVT prophylaxis

42
Q

why does A-fib put you at a higher risk for embolus

A

the atria doesn’t empty as well, and the blood with pool and thicken in the atria, then it clots, and travels

43
Q

what are the 2 types of hemorrhage

A

intracerebral and subarachnoid

44
Q

what are the potential causes of a hemorrhage

A

aneurism, arteriovenous malformation (AVM) and HTN

45
Q

what is arteriovenous malformation (AVM)

A

capillary beds are leaky

46
Q

what is hemorrhagic conversion

A

a complication of acute stroke. you have the tPA administered. the clotted vessels die, which weaken the surrounding vessels and then they break and leak, so you get a second hemorrhage

47
Q

what are the two types of hemorrhagic conversion

A

hemorrhagic infarction and parenchyma hematoma

48
Q

what are the predictors of hemorrhagic conversion

A

large infarct
A-fib and cerebral embolism
hyperglycemia
thrombolysis

49
Q

what are the causes of cerebral edema dan increased ICP

A

bleeding in to the brain or fluid around the brain

swelling in the brain (by ischemia)

50
Q

what are the signs and symptoms of cerebral edema and increased ICP

A

behavior changes, decrease consciousness, HA, lethargy, decline in neuro status, vomiting, seizures.

51
Q

what are the treatments for cerebral edema and increased ICP

A

osmotherapy, corticosteroids, and surgical decompression

52
Q

what are the determinants for CVA severity

A

location of lesion, size or extent, early acute management, amount of collateral blood flow, and amount of brain swelling.

Clinical Neuroscience (20 decks)

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