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ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM. Exemplar Cerebrovascular Accident(CVA) Introduction to CVA / Stroke Prevention. Stroke (Brain Attack). Definition -Blood flow interrupted to an area of the brain -Ischemia to the part of the brain -Bleeding into brain tissue - PowerPoint PPT Presentation
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ALTERATIONS IN THE ALTERATIONS IN THE CENTRAL NERVOUS CENTRAL NERVOUS SYSTEMSYSTEM
ExemplarCerebrovascular Accident(CVA)Introduction to CVA / StrokePrevention
Stroke (Brain Attack)Stroke (Brain Attack)Definition
-Blood flow interrupted to an area of the brain
-Ischemia to the part of the brain
-Bleeding into brain tissue-The brain doesn’t store
oxygen/ glucose and needs a constant flow of blood
Cerebrovascular AccidentCerebrovascular Accident Approximately 800,000 in USA annually (425,000=F; 370,000=M) *
Third most common cause of death #1 leading cause of disability
Physical, cognitive, emotional, & financial impact
*http://www.stroke.org/site/News2?page=NewsArticle&id=9015&news_iv_ctrl=1222
Transient Ischemic Attack (TIA)Transient Ischemic Attack (TIA)
Temporary focal loss of neurologic function
Caused by ischemia of one of the vascular areas of the brain
Most resolve within 3 hours
Difference of TIA vs. CVA is infarction*
*Easton,JD, Saver,JL, Albers, GW, et al. Definition and evaluation of transient ischemic attack.Stroke. 2009; 40(6)2276-2293.
Faculty animations from chtr 47 TIA
Types of StrokesTypes of StrokesIschemic stroke (87%)
-Thrombotic stroke: atherosclerosis of blood vessel wall -Embolic stroke: dislodged clot from other area of body
Hemorrhagic stroke (13%)Bleeding into brain tissue r/t
ruptured aneurysm, arteriovenous malformation
Faculty animation a fib cht 47
Cerebrovascular Accident: Cerebrovascular Accident: IschemicIschemic
Thrombotic Thrombotic Lumen of the blood vessels narrows
(atherosclerosis) - becomes occluded -infarction occurs
Associated with HTN and Diabetes Mellitus
Cerebrovascular Accident: Cerebrovascular Accident: IschemicIschemic
Embolic Stroke Embolic StrokeEmbolus lodges in/ occludes a cerebral artery
Infarction & cerebral edema developEmboli R/T : atrial fibrillation
-MI -valvular prostheses
Severe symptoms occur rapidly– no collateral circulation
Any age groupRecurrence common if underlying cause
not treated
Cerebrovascular AccidentCerebrovascular AccidentEmbolic StrokeEmbolic Stroke
Cerebrovascular Accident Cerebrovascular Accident Hemorrhagic Hemorrhagic
Subarachnoid Hemorrhage-Intracranial bleeding-Increases with age and
more common in women
Intracerebral Hemorrhage - rupture within the brain
tissueAneurysm
-abnormal blood vessel wall which ruptures
Cerebrovascular AccidentCerebrovascular AccidentHemorrhage Stroke Hemorrhage Stroke Intracerebral HemorrhageIntracerebral Hemorrhage
Cerebrovascular AccidentCerebrovascular AccidentPopulations at RiskPopulations at Risk
Age – Occurrence doubles each decade >55 years
Gender – Almost equal for men & women
Race – African Americans, Hispanics, Native Americans, Asian Americans -- higher incidence
Heredity – family history, prior transient ischemic attack, or prior stroke increases risk
http://www.stroke.org/site/PageServer?pagename=RISK
Pediatric StrokesPediatric StrokesPopulations at Risk
M>F; African American>White, Asian
Medical Hx -sickle cell disease -heart disease (congenital or acquired)
Signs & Symptoms -infant may have one sided seizure -older child has weakness/numbness
Video on Pediatric StrokeVideo on Pediatric Strokehttp://abcnews.go.com/Health/
video/year-stroke-survivor-10139867
Cerebrovascular AccidentCerebrovascular AccidentRisk FactorsRisk Factors
Controllable Risks with Medical Treatment & Lifestyle Changes:
High blood pressure DiabetesCigarette smoking TIA (Aspirin)High blood cholesterol ObesityHeart Disease Atrial fibrillation
Oral contraceptive use Physical inactivity
Sickle cell disease Asymptomatic carotid Hypercoagulability stenosis
PreventionPreventionMaintain healthy lifestyle
-exercise -don’t smoke/alcohol in moderation
Diet -low sodium, low cholesterol
Control underlying medical problems -hypertension -diabetes mellitus -atrial fibrillation