Onset is gradual and may be preceded by a tia it

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Onset is gradual and may be preceded by a TIA it often occurs at rest Minimal increases in ICP Effects are localized so there may be less permanent damage if collateral circulation has been established 2. Sudden obstruction caused by an embolus : lodging in a cerebral artery Atherosclerosis in the carotid artery of systemic circulation such as the heart Onset is sudden as the embolism moves into the cerebral circulation casing a acute onset of the neurological symptoms. Minimal increases in ICP in this type of CVA
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Effects are localized unless multiple emboli are present or if the embolus occluded the brain flow leading to a critical area of the brain 1. Intra cerebral hemorrhage : caused by rupture of a cerebral artery in patients with severe hypertension Effects are evident in both hemispheres and complicated by secondary effects of bleeding Etiology: hypertension and arteriosclerosis Onset is sudden and often occurs with activity Increased intracranial pressure is present and is high Effects of neurological injury are widespread, severe, and often fatal MRI or CT scan can determine the cause of a stroke If the initial scan is inconclusive, repeating it a few hours later, can document the injured area as the inflammatory response from the blood irritation will cause cerebral edema which is then visualized Risk factors of CVA Diabetes, hypertension, systemic lupus erythematous, atherosclerosis, history of TIA’s, increasing age, obstructive sleep apnea, heart disease, smoking, sedentary lifestyle Combination of oral contraceptives and smoking Congenital malformation of the blood vessels Increasing age Signs & symptoms of CVA Depend on the location of the obstruction Size of the artery involved (the presence of collateral circulation may diminish size of affected area) Lack of voluntary movement or sensation on opposite side of the body Initially flaccid paralysis Spastic paralysis develops weeks later NIH stroke scale (this was developed by the NIH to improve rapid diagnosis) Treatment options for CVA’s “Clot-busting” agents (there is a strict criteria for use), surgical interventions, glucocorticoids, supportive treatment, occupational and physical therapist, speech- language pathologist, treat underlying problem to prevent recurrences, and rehabilitation needs to begin immediately TIAS- S/S just like the stroke just not as drastic, these clear up in under 24 hours Transient Ischemic Attacks (TIAS) - Clear up after 24 hours May occurs singly or in a series they result from temporary localized reduction of blood flow to the brain: Partial occlusion of an artery Atherosclerosis Small emboli Vascular spasms Loss of auto regulation Signs & symptoms
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Difficult to diagnose after the attack Directly related to location of ischemia Intermittent short episodes of impaired function (ex: muscle weakness in arm and leg) Visual disturbances
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