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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