Term
How is stroke defined? - onset - where? - how? - for how long? |
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Definition
"The sudden onset of FOCAL or GENERALIZED neurological symptoms caused by ischema or hemorrhage and lasting 24 hours. |
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Term
What are the major types of stroke? (3) and what % do each make up of all strokes? |
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Definition
Ischemic stroke (85%) Intracerebral hemorrhage (10%) Subarachnoid hemorrhage (5%) |
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Term
Transient ischemic attack is when the symptoms resolve within ___ . How long does it usually take for a TIA to resolve? |
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Definition
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Term
How common are strokes worldwide? |
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Definition
1 in 6 people in the world will have a stroke |
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Term
What are some protective factors for stroke? |
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Definition
Smoke free Physical activity Healthy weight Eating fruits and veggies |
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Term
What is the impact of stroke on Canadians? |
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Definition
it is the #1 cause of disability in canadian adults if is the second or third cause of death |
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Term
For every 100 people who have had a stroke: 1. ___ will die within the first few weeks 2. ____ of those who live will be disabled |
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Definition
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Term
What % of strokes occur in people over the age of 65? |
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Definition
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Term
How does atherosclerosis lead to stroke? |
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Definition
Plaques are metabolically active chunks of garbage in your vessels that build up and narrow the blood vessels. Plaques that rupture cause the formation of blood clots that can block blood flow or break off and travel to another part of the body leading to ischemic stroke |
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Term
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Definition
failure of cerebral blood flow to a part of the brain |
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Term
What results from ischemia? |
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Definition
varying degrees of hypoxia |
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Term
Prolonged hypoxia becomes _____. This results in infarction which is complete cell death, which leads to _____. This is a stroke |
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Definition
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Term
What is ischemic penumbra? |
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Definition
the penumbra is the area surrounding an ischemic event such as an ischemic, thrombotic or embolic stroke.
cells here aren't dead yet, but will die if you don't do something about it |
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Term
What are some non-modifiable risk factors for stroke? |
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Definition
Previous stroke being old being male having a horrible family Hx |
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Term
IMPORTANT: What is the most important modifiable risk factor for stroke?! |
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Definition
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Term
How much does diabetes increase the risk of stroke? |
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Definition
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Term
How much does smoking increase a person's risk of ischemic stroke? |
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Definition
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Term
How much does smoking increase a person's risk of subarachnoid hemorrhage? |
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Definition
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Term
Why are serum lipids risk factors for stroke? |
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Definition
High blood levels of low density lipoprotein results in excessive amounts of LDL in the artery walls
--> you get LDL deposition in arteries from hypertension, smoking and diabetes |
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Term
Explain the relationship between alcohol and stroke. |
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Definition
Small amounts = protective Heavy drinking = increases risk by 2.5 times |
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Term
What is a risk factor for stroke that is relevant to women? |
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Definition
oral contraceptives with high estrogen content |
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Term
Describe the arterial supply to the brain Anterior --> Posterior --> |
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Definition
ant = internal carotid arteries post = vertebral arteries |
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Term
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Definition
when arterial branches meet each other |
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Term
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Definition
when arterial branches meet each other |
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Term
What supplies the anterior circulation? |
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Definition
branches of the internal carotid arteries:
- anterior cerebral artery - middle cerebral artery |
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Term
What would be the symptoms of an anterior cerebral artery stroke? |
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Definition
Paralysis of contralateral foot and leg Sensory loss over contralateral toes, foot and leg impairment of gait and stance |
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Term
What are the Sx of a middle cerebral artery stroke? |
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Definition
- paralysis and sensory impairment of contralateral side of the body - homonymous contralateral visual field loss - aphasia - unilateral neglect |
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Term
In a MCA, aphasia will occur if the lesion is on the ____ side of the brain. |
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Definition
DOMINANT (usually the left side) |
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Term
In an MCA stroke, unilateral neglect will occur if the lesion is on the _____ side of the brain |
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Definition
non-dominant! usually right hemisphere |
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Term
How do ischemic strokes occur? |
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Definition
- artery to artery embolism - local thrombosis - Hypoperfusion (not enough blood gets to brain) - arterial disection - hypercoaguable states cardiac embolism - small vessel disease |
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Term
What are the areas affected in a posterior circulation stroke (POCS) and therefore what Sx would we see? |
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Definition
Brainstem, cerebellum and thalamus, occipital lobe, temporal lobes
Coma, vertigo, N/V, cranial nerve palsies, ataxia hemiparesis or hemisensory loss, visual field defects |
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Term
What would be the work up for a stroke? |
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Definition
blood ECG CT of head MRI angiogram echocardiogram hyper-coaguable blood screen |
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Term
When might you be in a hypercoaguable state? |
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Definition
- Malignancy - post-partum - inflammatory causes (SLE) - dehydration - inherited pro-coagulant disorders |
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Term
What is an arterial dissection? |
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Definition
A tear involving the internal lining of an artery --> creates a false lumen and interrupts the blood supply |
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Term
What are the types of arterial dissections? |
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Definition
1. Spontaneous (like in a connective tissue disease) 2. Traumatic (local trauma or chiropractic manipulation) |
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Term
What are the goals of stroke treatments? (4) |
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Definition
1. Restore the blood supply 2. prevent the ischemic damage from spreading 3. Protect vulnerable brain tissue 4. Promote functional outcome |
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