Term
| A sudden loss of blood circulation to an area of the brain that results in destruction of surrounding brain tissue and a corresponding loss of neurologic function |
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Definition
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Term
| Often occur in well-appearing adults as a sudden, devastating vascular event that results in destruction of surrounding brain tissue. |
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Definition
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Term
| What is the primary cause of stroke? |
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Definition
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Term
| What is the most common and lethal neurologic disorder and the leading cause of serious long-term disability |
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Definition
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Term
| Name the 10 Controllable Risk Factors for Stroke |
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Definition
High BP
Atrial Fibrillation
High Cholesterol
Diabetes
Atherosclerosis
Circulation Problems
Tobacco use and smoking
Alcohol use
Physical inactivity
Obesity |
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Term
| Name the 7 Controllable Risk Factors for Stroke |
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Definition
Age
Gender
Race
Family History
Previous stroke or TIA
Fibromuscular Dysplasia
Patent Foramen Ovale |
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Term
| Name the 5 warning signs of stroke |
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Definition
-Sudden weakness or numbness of the face, arm or leg
-Sudden dimness or loss of vision, particularly in one eye
-Sudden difficulty speaking or understanding speech
-Sudden severe headache with no known cause
-Unexplained dizziness, unsteadiness, or sudden falls |
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Term
| An acute episode of temporary and focal neurologic symptoms that completely resolve within 24 hours; a vascular origin |
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Definition
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Term
| What is the etiology of a TIA |
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Definition
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Term
| What are the clinical manifestations of TIA? |
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Definition
-Rapid onset; similar symptoms of stroke
-The durations typically last 2-15 minutes = most are less than 1 hour |
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Term
| How are TIAs medically treated? |
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Definition
-Hospitalization, close observation and early use of imaging to determine level of brain damage
-Cardiac evaluation to help stratify risk and management of potential CAD
-Early management often includes blood thinners |
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Term
| Strokes cause by thrombosis or embolism. Accounts for 85% of all strokes |
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Definition
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Term
| Thrombosis and embolic occlusions of an artery are the most common causes for ischemic strokes. Which artery is the most common site of athersclerosis and atherothrombosis leading to stroke? |
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Definition
| Proximal Internal Carotid |
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Term
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Definition
-Most common source: the damage to heart tissue from atherothrombotic dz such as CAD and MI
-A-fib: thrombus formation
-Cardiac surgery: formation of emboli during or after heart surgery |
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Term
| How can occlusion of a major artery cause an ischemic stroke? |
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Definition
| Occlusion of the artery causes the major injury to the neurons in the brain. When cerebral blood flow drops significantly, neuronal function is impaired and neuronal death occurs as a result of hypoxia/ischemia |
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Term
| How can secondary vascular responses lead to ischemic stroke? |
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Definition
-After a cerebral artery has been occluded, thromboemboli form in the distal vessel of that artery resulting in the progressive impairment of blood flow in the brain
-Other factors effect microvessels: astrocyte swelling, bleeding into parenchyma, increased platelet aggregation, endothelial cells swelling and vasospasm
-These changes further damage brain cells |
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Term
| How can secondary neuronal damage lead to an ischemic stroke? |
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Definition
-Ischemic penumbra
-Uncoupling cerebral blood flow and metabolism in the infarcted area
-Changes in the neurotransmitters can cause further damange
-Excess glutamate accumulated resulting in postsynaptic overstimulation
-Results in excessive calcium which causes cell death
-Calcium also activates catabolic enzymes |
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Term
| What does a stroke in the middle cerebral artery result in? |
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Definition
| Hemiplegia, Hemianesthesia |
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Term
| What does a stroke int he internal carotid artery result in? |
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Definition
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Term
| What does a stroke in the posterior cerebral artery result in? |
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Definition
| Loss of pain, temperature, proprioception, touch |
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Term
| What does a stroke in the vertebral and posterior inferior cerebellar artery syndrome result in? |
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Definition
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Term
| What does a stroke in the basilar artery result in? |
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Definition
| Loss of sensory and motor aspects of cranial nerves |
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Term
| What does a stroke in the superior cerebellar artery result in? |
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Definition
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Term
| What does a stroke in the anterior inferior cerebellar artery result in? |
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Definition
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Term
| How can ischemic stroke be treated? |
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Definition
-Manage the stroke and prevent future ones
-Anticoagulation therapy
-Lower BP
-Neuroprotection
-Surgery
-Control of symptoms |
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Term
| Spontaneous bleeding from an arterial source into brain parenchyma. This type of stroke accounts for 10-15% of all strokes and is the most deadly type of stroke. |
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Definition
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Term
| Spontaneous bleeding in the absence of a readily indentifiable precipitant and is usually attributable to microvascular disease associated with hypertension or aging |
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Definition
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Term
| Occurs most often in association with trauma, impaired coagulation, toxin exposure, or an anatomic lesion |
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Definition
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Term
| What is the pathogenesis for hemorrhagic stroke or ICH? |
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Definition
-Chronic HTN causes fibrinoid necrosis in the penetrating and subcortical arteries, weakening of the arterial walls, and formation of small aneurysmal outpouchings, or microaneurysms, that predispose patients to spontaneous ICH
-Bleeding usually arises fromt he deep penetrating arteries of the circle of Willis, including the lenticulostriate, thalamogeniculate, and thalamoperforating arteries and perforators of the basilar artery
-Acute rises in BP and blood flow can also precipitate ICH even in the absence of pre-existing severe HTN
-A ruptured vascular malformation is the second most common cause of ICH |
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Term
| What represents the single most important modifiable risk factor for ICH? |
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Definition
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Term
| __ __ __ causing abnormal changes in the vessels of the brain accounts for approximately 10% of ICHs. Its reorganized as an important cause of ICH in the elderly. |
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Definition
| Cerebral Amyloid Angiopathy |
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Term
| Excessive use of alcohol has been associated with massive spontaneous __ |
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Definition
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Term
| Cocaine and amphetamine use is acknowledged as an important cause of __ |
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Definition
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Term
| What are the clinical manifestations of Hemorrhagic stroke or ICH? |
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Definition
-Neurologic symptoms depend on location, also with headache, seizure
-Pts with hemorrhagic stroke present with similar focal neurologic defitis but tend to be more ill than pts with ischemic stroke
-Pts with intracerebral bleeds are more likely to have headache, altered mental status, seizures, N&V, and/or marked HTN; however, none of these findings distinguish reliably between hemorrhagic and ischemic strokes |
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Term
| How are hemorrhagic strokes or ICH treated? |
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Definition
Reduce BP
Control and reduce brain edema
Supportive care
Anticonvulsant therapy |
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Term
| Accumulation of blood in the subarachnoid space; 90% are caused by ruptured berry aneurysm |
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Definition
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Term
| What is the pathogenesis of subarachnoid hemorrhage? |
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Definition
| Hemorrhage/bleeding may continue until the severe headach, decreased consciousness or coma begin to occur |
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Term
| How are subarachnoid hemorrhages treated? |
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Definition
Surgery
Spontaneous recovery |
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Term
| Caused by the tearing of veins in the subdural space; often caused by trauma. Results in the accumulation of blood in the subdural space; causes compression of the brain and may cause local lesions. |
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Definition
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Term
| Manifests as a decrease in consciousness and various neurological symptoms. May need surgery to treat or could result in a spontaneous recovery. |
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Definition
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Term
| Very rare; can develop as a result of vessel malformation, viral infection, MS,, and degeneration; same causes of cerebral infarcts |
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Definition
| Spinal Cord Vascular Disorders |
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Term
| Results in a spinal cord lesion and manifests as flaccid extremeties, muscle atrophy, pain and burning below the lesion, bowel/bladder dysfunction |
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Definition
| Spinal Cord Vascular disorders |
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Term
| How are spinal cord vascular disorders treated? |
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Definition
| Surgery or spontaneous recovery |
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Term
| What 2 things are common in cerebral hemisphere and internal capsule strokes? |
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Definition
Loss of sensation
Loss of motor control |
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