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

• 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 SignsPrior StrokeTIA (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 laterHeadache

Symptomsspinothalamic 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

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