OCCTH 585 - Stroke Questions & Answers Already Graded A +

Five Main Warning Signs - Answer-1. Vision Problems 2. Weakness 3. Trouble Speaking 4. Headaches 5. Dizziness FAST acronym - Answer-Face - Looks uneven Arm - one arm hanging down Speech - Slurred speech? Time - Call 911 now! Cerebrovascular Accident (CVA) - Answer-Depends on the side of lesion or hemmorhage - - Right CVA = left hemiplegia - Left CVA = right hemiplegia Ischemic stroke - Answer-~80% of strokes - ischemic necrosis - infarction - hypo-perfusion Infarcts may occur as a result of thrombosis or embolism Hemorrhagic Stroke - Answer-~20% of strokes - bleeding - prognosis is more extreme - depends on how soon after the help is - more of a spectrum depending on how much brain tissue dies outTransient Ischemic Attack - Answer-- mild stroke that progressively leads to an ischemic stroke - might not be so severe that they need emergency help at that stage - 80% will have another stroke again requiring medical attention Thrombosis (Ischemic) - Answer-formation of thrombus, worsen by atherosclerosis (narrowing of the arteries) Embolism (Ischemic) - Answer-- process by which the blood vessel is getting stuck - large piece of thrombus or embolus breaks down, comes off in smaller pieces - travel to capillaries and usually get stuck and that is how infarction occurs Atheroslerosis (Ischemic) - Answer-LDL - low density lipoprotein - bad lipids accumulate on blood vessel walls HDL - high density lipoprotein - picks up cholesterol from tissue cells and transports it to the liver for disposal Therefore HDL to LDL ratio is a good indicator for heart attacks or stroke Surgical embolization - Answer-- due to surgical conditions, person could be predisposed to risk of embolism or stroke - example: fibroid - benign tumors - catheter insertion in femoral artery - surgically insert some materials to block the blood supply to the fibroid (intentionally creating an infarction) - could increase the risk of stroke Cardiac Emboli - Answer-If someone has issues with their heart (i.e. atrial fibrillation, arrhythmia) they are more likely to have blood clots in the heart chamber (i.e. stroke) Occurence (Ischemic) - Answer-progressive symptoms Spread across hours or days Mild arm numbness, morning paralysis Onset during sleep or resting at night time Often present with transient ischemic attacks before actual infarctionRisk Factos (Ischemic) - Answer-Age Cardiac disease - AF, MI Hypertension Blood lipids Diabetes mellitus Obesity Cigarettes smoking Excessive alcohol consumption Some drugs Circle of Willis - Answer-ICA - branches to the MCA Basilar artery - branches to the PCA At the base of the brain, the carotid and vertebrobasilar arteries form a circle of communicating arteries known as the Circle of Willis. From this circle, other arteries—the anterior cerebral artery (ACA), the middle cerebral artery (MCA), the posterior cerebral artery (PCA)—arise and travel to all parts of the brain. Posterior Inferior Cerebellar Arteries (PICA), which branch from the vertebral arteries, are not shown. Because the carotid and vertebrobasilar arteries form a circle, if one of the main arteries is occluded, the distal smaller arteries that it supplies can receive blood from the other arteries (collateral circulation). MCA Stroke - Answer-More common than ACA, PCA Larger portion Internal carotid artery Motor, sensory, cognition Sometimes homonymous hemianopsia Distal vs proximal location (in terms of motor deficits)