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Stroke
Definition
Cerebrovascular accident (CVA)
The rapidly developing loss of brain functions due to
disturbance in the blood supply to the brain
Classification
• Ischemic stroke (cerebral infarction)
decreased blood supply to some part of the brain
– Trombosis
– Embolism
– Systemic hypoperfusion (shock...)
• Haemorrhagic stroke (hemorrhage)
accumulation of the blood inside of some part of the
brain or inside the skull but outside the brain
– High blood pressure
– Aneurysm
Risk factors
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hypertension (hemorrhagic stroke)
atrial fibrillation (embolic stroke)
high cholesterol level (trombotic stroke)
cigarette smoking (trombotic stroke)
obesity
family history of stroke
diabetes
endocarditis (embolic stroke)
atherosclerosis, coronary artery disease (trombotic stroke)
hypoxemia (systemic hypoperfusion)
sickle cell anemia (trombotic stroke)
cocaine use (hemorrhagic stroke)
fractura (embolic stroke)
Signs and symptoms
Warning Signs
Prior Stroke
TIA (transient ischemic attack)
- mini stroke
- change in the blood supply to a particular part of the brain for
less than 24 hours (more than 24 hours = stroke)
• Sudden numbness or weakness of face, arm or leg,
especially on one side of body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or
coordination
• Sudden severe headache with no known cause
- 1/3 of people who have a TIA will have a stroke later
Headache
spinothalamic tract, corticospinal tract, dorsal column
• hemiplegia and muscle weakness of the face
• numbness
• reduction in sensory or vibratory sensation
brainstem
• altered smell, taste, hearing, or vision (total or partial)
• drooping of eyelid (ptosis) and weakness of ocilar muscles
• decreased reflexes: swallow, pupil reactivity to light
• decreased sensation and muscle weakness of the face
• balance problems and nystagmus
• altered breathing and heart rate
• weakness in sternocleidomastoid muscle with inability to turn head to one
side
• weakness in tongue (inability to protrude and/or move from side to side)
cerebral cortex
• aphasia (inability to speak or understand language)
• apraxia (altered voluntary movements)
• visual field defect
• memory deficits
• disorganized thinking, confusion
cerebellum
• trouble walking
• altered movement coordination
• vertigo and/or disequilibrium
Symptoms
Act FAST
Face: Does one side drop?
Arms: Dies one arm drift downward?
Speech: Are the words slurred?
Time: In any answer is yes, time is critical