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neuro-stroke

etiology, stats, pusher syndrome

QuestionAnswer
what is stroke? focal injury to the brain caused by a disruption of the brain's blood supply
what is the first cause of chronic and permanent functional disability? stroke
what happens to the incidence of stroke after age 55? doubles
which season is considered the "stroke season"? spring
Which ethic group is at higher risk for having a stroke? african americans
what is the risk of a second stroke after having a first stroke? 25-40% in 5 yrs
when is the risk the greatest to have a second stroke and which gender is at greater risk? first 30 day and males
what are the warning signs of stroke? think FAST ( fallen face, falls, Assymmetries, speech 1) sudden weakness/numbness of face, arm, or leg 2) sudden dimness or loss of vision esp. in one eye 3) sudden diff speaking or understanding speech 4) sudden severe headache w/ no known cause 5) unexplained dizziness, decreased steadiness or sudden falls
what are hidden risk factors for women? migranes with auras, birth control pills, hormone replacement therapy, autoimmune disease, clotting disorders
what is the percent of blood supply to the brain? 15-20%
What happens when the blood is totally prevented from reaching the brain for about 10 seconds? loss of consciousness
When does irreversible brain damage begin to occur? 3-5 minutes
What is the total blood flow to the brain? 700-1000 ml/min
which major arteries supply the brain? vertebral basilar system and internal carotids
What are the two major kinds of strokes and which one is more common? ischemic (more common) and hemorrhagic
T/F a stroke only effects one side of the body FALSE cross-talk occurs in the brain and integration of both sides
What are the 4 types of ischemic stoke? 1) thrombotic infacts (atherosclerosis), embolism (heart), large vessel infarcts, small vessel infarcts (lacunar)
What results after complete ischemia? irreversible brian damage within minutes
What is an ischemic penumbra? the zone surrounding brain region of complete iscehemia- some blood flow is preserved and if blood is restored to this area in a timely manner then there is recovery of function
T/F HTN may be beneficial post ischemic stroke to restore neurons to the penumbra TRUE
Where is the stroke if the face, arm, weakness, nonfluent aphasia MCA superior division
Where is the stroke if the fluent aphasia, right visual field deficit MCA inferior division
Where is the stroke if there is pure right motor hemiparesis and cortical deficits MCA deep territory
Where is the stroke if the contralateral LE weakness (frontal lobe dysfunction) ACA
Where is the stroke if the contralateral homonymous hemianopsia PCA
What is the result when blood supply to 2 adjacent cerebral arteries are compromised? watershed infarcts
T/F A watershed infarct can occur if there is a severe drop in BP TRUE
T/F Anticoagulation is effective in acute stroke FALSE it is innefective
T/F Anticoagulation is effective in hemorrhage FALSE it is innefective
T/F Anticoagulation is effective in preventing a stroke TRUE
WHen should t-PA be given to a pt following a stroke within 3 hours
What is the goal of neuro-protective therapy? improve ability of brain cells to withstand a period of ischemia until blood flow is restored
what are non surgical interventions following stroke? manage BP, blood sugars, temperature, early moilization, early therapies
What is the number one treatment for stroke? prevention
What is the definition of a TIA compared to a stroke? stroke with a complete recovery
T/F A TIA is a high potential for a major CVA TRUE
What are TIA symptoms? sudden weakness of one arm, leg, side of body, inability to speak, loss of vision in one eye, symptoms usually clear in a few minutes and are painless and easy to ignore
T/F a TIA is considered a mini stroke FALSE there are some permanent changes in a mini stroke
What is Pusher Syndrome? the pt pushes towards the bad side, which is different than the "normal" presentation of a stroke pt
T/F Neglect is the reason for Pusher Syndrome FALSE neglect and aphasia are assocaited but not the cause
Pusher Syndrome can be caused by a right and/or left CVA? Either Right or Left
What part of the brain is likely to be involved in Pusher Syndrome? thalamus, relay structures esp. in the vestibular pathways
What 2 systems are experiencing conflict in Pusher Syndrome? vestibular "vertical" and visual, if visual is taken away they will report they feel midline when they are 18 degrees over
What is the perceived "upright" orientation in Pusher Syndrome? about 18 degrees to the involved side (ipsilateral)
What is the prognosis of Pusher Sydrome dependent on? aphasia, spatial neglect, visual abilities
What is the treatment for pts with Pusher Syndrome? realization of actual midline, using vision to orient upright position, learn movements to reach vertical position, immobilize pushing arm and leg
T/F It would be beneficial to use an AD with a pt with Pusher Syndrome FALSE, maybe a rolling platform walker
T/F A pt with Pusher Syndrome must find postural vertical before he or she can begin functional activities TRUE
T/F the therapeutic transfer for this population is towards the strong side FALSE
T/F Using hard plastic is a good method to immobilize the strong extremities FALSE, they impede sensory information and should not be the first line of use
What are means of preventing a secondary stroke? management of heart disease, HTN, DM, hpercholesterolemia, antiplatelet therapy, etc.
T/F a TIA is not a medical emergency FALSE
Created by: Leeli.PT