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Stack #240092
| Question | Answer |
|---|---|
| Stroke is an | acute, local reduction in perfusion of the brain caused by occlusion,stenosis, or rupture of a vessel supplying blood to the brain |
| Types of stroke are | ischemic (accounts for 83%) or hemorrhagic |
| Ischemic there are 3 types | large artery atherosclerotic(large vessel occlusive disease), Embolism (cardioembolism), Lacunar stroke (small vessel occlusive disease) |
| Large artery atherosclerotic stroke | most often the MCA, 1/2 of the vessel is occluded by atherosclerotic plaque, & the other 1/2 by thrombus, high mortality rate |
| Embolism stroke | embolism that traveled from the heart to the brain & produced an obstruction in the brain. Also occurs due to cardiac structure change i.e. rhythm disturbance a-fib, endocarditis, valvular heart disease, AMI, CA, traumaa treated w/ coagulants |
| Lacunar stroke | seen in patients who smoke/HTN/DM |
| IC hemorrhage | damaged vessels in brain rupture, blood infiltrates parenchyma, sudden increase in pressure can damage brain and lead to ischemia distal to bleed |
| Risk factore of IC hemorrhage | uncontrolled HTN, bleeding disease, use of anticoagulants, excessive ETOH consumption & drugs |
| Subarachnoid hemorrhage | a blood vessel ruptures & blood leaks into the membrane surrounding the brain |
| Subarachnoid hemorrhage caused by | cerebral aneurysm, AVM, trauma other |
| Aneurysm | a weak area in blood vessel that enlarges out of the vessel usually in the circle of wills at the bifurcations most common & easiest to treat berry or saccular aneurysm |
| AVM | masses of abnormal vessels which grow in the brain, unruptured AVM can cause HA, sometimes the only presenting sign |
| 2 Zones of injury | 2 within the cerebrovascular bed core ishemic zone (NOT VIABLE LONG) penumbra (VIABLE FOR SEVERAL HOURS) |
| Intracranial aneurysm rupture results in | accumulation of blood in the subarachnoid space, clogging the arachnoid villi leading to hydrocephalous, risk for vasospasms, preventing vasospasming is vital |
| MCA stroke symptoms | loss of movement & sensation on contralateral side |
| PCA stroke symptoms | CNIII palsy, weakness & ataxia, coma, unreactive pupils & decerebrate rigidity |
| Basilary artery stroke symptoms | dizziness, lightheadedness |
| If stroke symptoms improve quickly most likely | ischemic stroke |
| Differentiate stroke from stroke mimic ie.e | seizures, systemic infections, brain tumors, toxic metabolic conditions low NA, hypo/hyperglycemia, high Ca |
| Stroke diagnosed via | noncontrast CT/MRI, blood glucose, e-, 12 lead ECG, cardiac biomarkers, CBC, PT/INR, aPTT, O2 sa |
| For candidates for treatment with tpa goal | scan completed w/i 25 minutes & interpretation w/i 20 min |
| For administration of thrombolytic therapy patient must | 18 years, apparent neurological deficits consistent w/ ischemic stroke, onset of symptoms was < 3 hours before the beginnin of the infusion, Ct scan - for hemorrhage |
| BP control indicated in certain groups | thrombolytic therapy if elevates post therapy |
| Temperature control | temperatures have a poor neurological outcome in acute ischemic stroke patient |
| glucose monitoring | promotely correct hypo/hyperglycemia to prevent brain injury |
| Thrombectomy | removal of thrombus via the femoral artery up to the cerebral circulation can be done w/i 8 hours of onset of symptoms |
Created by:
tauvia2003