quiz #3- cerebrovascular disease
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quiz #3- cerebrovascular disease
Strokes are the ____ leading cause of death in the US
What are some random facts about strokes?
every 40 seconds someone has a stroke
strokes kill more women than breast cancer yearly
leading cause of long term disability
What are the two different types of CVAs and their difference?
: 13% of CVAs- arterial blood bleeds out
: 87% of CVAs- blockage of arterial blood
What are causes of hemorrhagic stroke?
How does hypertension cause a stroke?
microaneurysms form and burst, leaving pockets of brain damaage
What are the defecits caused by a HTN stoke like?
defecits are minor per stroke, but they are cummulative
How do aneurysms cause a stroke?
weak arterial wall --> ballooning of wall --> rupture into arachnoid space
What are some of the statistics of aneurysms?
50% die within 6 months
1/3 of survivors have neurological defecits
incidence higher in women
mean age is 50 years
How does arteriorvenous malformation cause a stroke?
arterial vessels feed directly into veins and high pressure causes bleeding
What are some characteristics of ateriovenous malformation?
2% of hemorrhagic strokes
occurs between 20-40yo
What are signs/symptoms of a hemorrhagic stroke?
sudden, severe headaches
nausea and vomitting
aversion to light
weakness/numbness in arm/leg
loss of consciousness
What are the two types of blockage that can occur in occlusive strokes?
: vessels at site slowly build a plug
: plus moves around and eventually gets stuck
What are causes of occlusive strokes?
Where does artherosclerosis offten occur?
middle cerebral arteries
What are risk factors for atherosclerosis?
increased serum lipids
What is arteritis and when does it occur?
inflammation of arteries
occurs in lupus, syphillis, and polymyositis rheumatic
What are signs and symptoms of an embolus?
symptoms may improve rapidly (transient ischemic attack)
usually <50 yo
What are signs and symptoms of a thrombus?
history of HTN or atheroclerotic heart disease
symptoms progress (tingling, weakness, dizzy, aphasia)
What is a transient ischemic attack?
from an embolus (plaque in carotid artery)
puts you at risk for a major stroke
often in young people 30-40
What are symptoms of transient ischemic attack adn how long do they last
usually resolve in 24 hours
: blind in one eye, occlusion of opthalamic artery
What are characteristics of a middle cerebral artery?
contralateral hemisensory loss (look by modality not dermatome)
What are characteristics of anterior artery stroke?
only 1% of strokes
marked weakness in contralateral leg
no sensory loss b/c sesnory strip is deep
possible personality changes
expressive aphasia if in dominant hemi
apraxia if in non-dominant hemi
What are characteristics of posterior cerebral artery stroke?
3% of strokes
homonymous hemianopsa (loss of visual field on same side)
possible thalamic pain
possible cerebellar ataxia
What are characteristics of posterior inferior cerebellar artery stroke?
dysarthria- motor dysfunction of speech
dysphagia- motor dysfunction w/ swallowing
contralateral loss of pain/temp in body, ipsilateral in face
What are characteristics of vertebral and basilar artery strokes?
ipsilateral facial weakness
locked in state- can only move eyes
How can you diagnose a stroke?
history of signs/symptoms
How do you treat a stroke?
clot buster if within 6 hours
maintain airway if unconscious
maintain hydration and electrolyte balance
prevent cerebral edema
bowl and bladder care
prevent contractures, skin ulcers, and thrombophlebitis
What is the prognosis of a stroke?
10% return to work
40% have residual disability (may be independent at home)
50% have severe disability (help with ADL)
What are consequences of stroke?
changes in muscle tone/strength
synergist movement (move in patterns)
aphaisa (dominatn hemi)
sensory loss (check by modality)