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31 Cards in this Set
- Front
- Back
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Stroke |
Sudden onset neurologic dysfunction due to cardiovascular disease that results in an area of brain infarction 3rd leading cause of death Most common form of stroke is ischemia |
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Stroke Epidemiology |
Females affected more often than males Most stroke victims are > 65 years of age |
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Stroke Signs and Symptoms |
Issue/difficulties with speech Face paralysis (usually one sided) Weakness Issues with coordination Vision problems |
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Stroke Risk Factors |
Similar to those of atherosclerotic vascular disease: Hypertension Diabetes Mellitus Hyperlipidemia (High lipid counts in blood) Smoking |
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Ischemic Stroke (Too Little Blood Flow) |
Result from sudden occlusion of cerebral artery secondary to thrombus formation or emboli |
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Thrombotic Strokes |
Associated with atherosclerosis and coagulopathies |
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Embolic Strokes |
Associated with cardiac dysfunction or dysrhythmias |
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Thrombotic Therapy |
Main goal is salvaging the penumbra (ischemic but viable tissue) Treatment must be instituted within 3 hours of symptoms onset to be maximally effective |
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Hemorrhagic Stroke (Too Much Blood Flow) |
Hemorrhage with the brain parenchyma (functional tissue in the brain) Usually occurs secondary to severe, chronic, hypertension Most occur in basal ganglia or thalamus Degree of secondary injury and associated morbidity and mortality is much higher in hemorrhagic stroke than ischemic stroke |
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Time of Stroke Onset |
Important The more time that passes means greater degree of brain damage as tissue lacks blood flow |
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Treatment |
Cardiovascular stabilization Brain CT determines type and location of stroke |
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Ischemic Stroke Treatment |
Treatment aimed at minimizing infarct size and preserving neurologic function Get as much blood flowing into the area to save viable tissues |
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Hemorrhagic Stroke Treatment |
Blood pressure management Inter-cranial pressure monitoring and management |
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Cerebral Aneurysm and Arteriovenous Malformation |
Structural abnormalities of the cerebral arteries predispose to intracerebral bleeding and hemorrhage Cerebral aneurysms and anteriovenous malformation are the most common causes of subarachnoid hemorrhage |
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Cerebral Aneurysm |
Lesion of an artery that results in dilation and ballooning of a segment of the vessel Congenital defect of the medial layer of the artery weakens to arterial pressure, allowing the dilated portion to fill with blood and eventually burst causing subarachnoid hemorrhaging |
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Cerebral Aneurysm Signs and Symptoms |
Severe headache with meningismus |
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Cerebral Aneurysm Treatment |
Surgical stabilization with aneurysm clipping or embolization |
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Arteriovenous Malformation |
Capillary system fails to develop appropriately with arterial blood shunted directly into the venous system Causes the vessels to progressively enlarge Becomes a congested mass of enlarged vessels that can burst |
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Arteriovenous Malformation Signs and Symptoms |
Seizure and neurologic dysfunction |
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Arteriovenous Malformation Treatment |
May entail craniotomy for surgical removal Gamma knife/sterotactic radiosurgery Irradiation Embolization |
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Central Nervous System Infections |
Organisms may gain access to the CNS through the bloodstream, direct extension from a primary site or along peripheral and cranial nerves, or through maternal-fetal exchange Meningitis and cerebral abscess commonly associated with bacterial infections; encephalitis is usually viral |
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Meningitis |
Bacteria usually reach the CNV via the bloodstream or extension from cranial structures Bacteria invade leptomeninges; accumulation of inflammatory exudate can result in obstructive hydrocephalus (fluid on the brain) |
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Meningitis: Most Common Bacteria |
Streptococcus pneumoniae Neisseria meningitidis |
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Meningitis Signs and Symptoms |
Stiff neck (Hallmark symptom) Headache Flu like symptoms |
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Meningitis Treatment |
Involves intravenous antibiotic therapy and supportive measures |
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Encephalitis |
Inflammation of the brain commonly caused by West Nile virus, western equine encephalitis, and herpes simplex (type 2) Caused by a virus only |
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Encephalitis Signs and Symptoms |
Fever Headache Malaise Muscle pain And/or rash |
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Encephalitis Treatment |
Supportive with control of symptoms Includes antipyretics Antiseizure medication Fluid resuscitation |
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Brain Abscess |
Localized collection of pus within the brain parenchyma |
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Brain Abscess Signs and Symptoms |
Presents as space-occupying lesion with changes in level of consciousness and typically with signs of infectious etiology |
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Brain Abscess Treatment |
Drainage and/or excision of the abscess with IV antibiotic therapy |
