Term
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Definition
| cerebral vascular accident |
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Term
| interal carotid artery pathways |
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Definition
| posterior communicating, aterior cerbral, middle cerebral (entire lateral surface) |
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Term
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Definition
| incased in spinal column, more posterior supplies cerebellum and brain stem |
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Term
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Definition
| where the personality, speech, emotion, helps dictate our behavior and planning |
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Term
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Definition
| memories, long term and short, also plays a role in language, smells and sounds |
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Term
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Definition
| ability to feel pain, can tell what something is when you place it in there hand |
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Term
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Definition
| this lobe; visual stimulation, gives meaning to what you see |
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Term
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Definition
| respobsible for heart rate, breathing, alertness |
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Term
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Definition
| about 7,900 suffer from this, up to 80% survive now, most commone cause of long term morbidity, top cause of death by disease |
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Term
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Definition
| what percent of the body O2 is concumed by the brain, the brain does not tolerate ischemia |
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Term
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Definition
these are risks for what?
smoking, high blood pressure, drinking ( 10 standard drinks in the past week associated with brain attacks, alcohol caues heart rhythm diturbances) infections, dental procedures, heart problems, kidney dieases, obesity, family history, history of TIAs |
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Term
| Outcomes of ishemic episode |
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Definition
1. duration- reversible if ishemia only last 4-6 minutes, irreversible after 10
2. extent- location of brain attachand how much tissue is damaged
3. adequacy of collateral circulation-if it takes place slowly the brains circulation will help oxygenate it, help minimize damage. |
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Term
| classifications according to symptoms |
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Definition
1. TIA
2. reversible ishemic neurologic deficit
3. stroke in evolution
4. completed stroke |
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Term
| Reversible Ishemic neruologic defict (RIND) |
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Definition
| has some sort of event that no long term problem, last longer than TIA |
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Term
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Definition
| this is a period of time from acute onset through continuing deterioration in symptoms, can be hours or days |
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Term
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Definition
| this stabilizes in terms of symptoms, not deteriorating any further |
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Term
| Transient ischemic attack |
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Definition
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Term
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Definition
about 500,000 suffer from it in a year, mini stroke and are reversible
brief episode of neuron dysfunction with no apparent vascular causes, Warning sign
should go to the emergency room |
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Term
TIA percentages
after having a TIA this is when a brain attack can occur |
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Definition
8% will have a brain attack within a month
12% within 1 year
30% within 5 years |
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Term
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Definition
| causes aterosclerotic plaque, carotid artery stenosis, large vessel disease, small vessel disease, cardioembolism |
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Term
| warning signs/symptoms of TIA |
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Definition
| this depending on area affected, sudden headache and worse than they have ever had, transient numbness, paralysis, difficulty speaking, difficulty swallowing, suden loss of vision, dizziness |
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Term
| assessment for person with TIA |
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Definition
| timing, ABCs, Hx, physical assessment, VS, labs, neuro checks |
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Term
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Definition
CT, MRI, angiography, ultrasound, ECG
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Term
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Definition
anti platelet therapy, asprin, persantine- which pervents aggrivation
plavacts- effective antiplatelet medications, better than asprin, need to make sure you know what is the cause of TIA, bad if they are bleeding
cardio- put on anticoagulation |
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Term
surgical managment
(coratidiendoectomy) |
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Definition
| inclusion more than 70%, patient has not had a neuro event, remove the inclusion and put a stent in and blood patch |
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Term
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Definition
| 75% of all brain attacks, most common, onset prgresses very slowly |
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Term
| Etiology of Thrombotic brain attack |
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Definition
| Atherosclerotic, endothelial damage |
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Term
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Definition
| bifurcation of internal and eternal carotid arteries |
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Term
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Definition
| plagues, change in blood flow dynamics, formation of microembolic compsed of platelets and fibrin arterial damage (ulceration), obstruction or emboli |
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Term
| onset of thombotic brain attack |
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Definition
| often happens while sleeping or 1 hours after waking up, beacause of low blood pressure, it is not high enough to push the blood through and causes anoxia |
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Term
| Clinical manifestations of Thrombotic brain attack |
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Definition
| dizziness, aphasia, disarthria, posterior arteries supply the cerebellum and will have a weakness on both sides, problems swallowing, balance problems |
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Term
| cerebellum and basil ganglia |
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Definition
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Term
| Treatment of Thrombotic brain attack |
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Definition
Medical TPA- clot buster, have to come within 3 hours of the symptoms, dont do this with everyone, have to make sure the stroke is not caused by bleeding
surgical - coratidendoectomy: removel of inclusions |
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Term
Embolic brain attack
etiology |
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Definition
| thrombus from presence of cardiac disease, valve disorder, cardiomyopathy, arrhythmia, a piece of fat or tumor that breaks off, effect a small area of the brian |
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Term
| onset of embolic brian attacks |
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Definition
| awake and active time of day, cardiac or a broken off segment of a thrombus, not as extensive as the other two attacks |
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Term
| damage of embolic brain attack |
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Definition
| middle cerebral artery (MCA) |
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Term
Hemorrhagic brain attack
etiology |
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Definition
| bleeding directlyinto brain tissue, slowest recovery, and causes more deaths, most dangerous |
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Term
| onset of hemorrhagic attack |
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Definition
| active time of day, terrible headache, increase ICP, chronic hypertension, sudden increase in b/p can cause tears. |
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Term
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Definition
| widen pulse pressure- greater distance between systolic and iastolic, bradycardia, respiratory becomes very erratic |
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Term
hemorrhagic attack
(damage) |
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Definition
| damage to white matter, develop hematoma and causes brain matter to shift |
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Term
Hemorrhagic attack
treatment |
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Definition
| this depends on size and location, control they hypertension, don't want b/p to go too low because the cranical pressure will drop, vitamin K to stop the bleeding, can go in and remove a part of cranium and brain is able to swell, and then replace it later |
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Term
| Lacunar/ small vessel disease |
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Definition
| mirco infarcts smaller than 1cm diameter, involve small arteries deep in the brain, can affect very critial areas |
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Term
| cause of small vessel disease |
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Definition
| atherosclerosis associated with HTN and diabetes, mini srokes and you may never know it |
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Term
| symptoms of vessel disease |
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Definition
| motor hemi paresis- clumsy hands, can feel it but it is weak, difficult speaking |
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Term
| pathophysiology of ischemic brain attack |
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Definition
nerosis begins within minutes (death of living cells or tissue) areas are soft with in 6-12 hours
edema peaks in 3-5 days
potential incrase intracranial pressure
interuption of brain cell funciton |
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Term
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Definition
- damage to neurons- ishemic cells unable to produe ATP
- cell membranes beocome depolarized
- dying neurons secrete excessive amounts of Glutamate
- cells are unable to remove excessive glutamate
- NMDA binding allows abnormal movement of calcium and sodium into cells
- increased ICF levels of Ca
- neurons die as a result of calcium activated protease and free radical damage
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Term
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Definition
region that surrounds ishemic core, cells are dieing, but this helps so the body doesnt lose complete function
area of low blood flow only 20% enough to keep them alive for about 3 hours |
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Term
| Thrombosis, then hemorrhage and embolism |
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Definition
| most common cause of brain attack |
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Term
medications
tissue plasminogen activator (TPA) |
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Definition
| success when suffered MI helps to beak up clots and need to be treated within 3 hours of symptoms |
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Term
medicaiton
NMDA antagonist |
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Definition
this medication competes with glutamate, no allowing calcium influcts into cells, given early on can lead to a decrease in neuro injury, not good with alzheimers patients
memantine (namenda) |
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Term
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Definition
this medication impedes calcium into cells;
nimodopine, nicadipine, aptigonel |
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Term
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Definition
| this medication, vitamin E, help decrease free radicals |
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Term
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Definition
this medication decrease in influcts of calcium and help blood vessels in the brain
-dextrophan |
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Term
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Definition
heparin (LMWH)
halteparin |
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Term
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Definition
| need to control hypertension, b/p needs to be at a certain point so you know the brain is perfusing |
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Term
| things to know about brain attacks |
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Definition
- want ot minimize damage, and maximize recovery
- ABC- aiway, breathing, circulation
- fluid- do not give a lot it will cause cerebral edema, sometimes match cc for cc
- watch for develping temp- maybe the brain stem is infected increases metabolic rate which increases the consumption of oxygen
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Term
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Definition
| this drug naturally produced, given synthetically helps improve connection in the brain, motor skills |
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Term
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Definition
| weakness on one side of the body |
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Term
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Definition
| complete inability to move |
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Term
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Definition
| difficult finding the words to speak |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| lossed ability to recognize an object, sounds, shapes or smells |
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Term
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Definition
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Term
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Definition
| inability to do math skills |
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Term
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Definition
| inability to plain tasks, like brushing teeth |
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Term
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Definition
| loss of one half of the vesual field |
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Term
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Definition
| patient can speak but can't name things, diffuclt to communicate in the right manner, frontal lobe, is expressive |
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Term
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Definition
| receptive and expressive, really lost, can talk but dont make sense, understand spoken words but can not speak back |
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Term
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Definition
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