LEFT HEMISPHERE CVA Right sided weakness/hemiplegia Aphasia Slow performance Visual field deficits RIGHT HEMISPHERE Left sided weakness/hemiplegia Spatial-perceptual deficits o Increased vulnerability to accidents Tends to minimize problems Short attention span Impaired judgement Impaired time concept TYPES OF CVAs Occlusion of an artery by an atheroma o Atheroma = fatty deposits and scarring that leads to tissue breakdown of the artery walls o Often develop in large arteries o Can trigger the formation of thrombosis ( THROMBUS )(blood clot) o Onset is gradual o May be preceded by transient ischemic attacks (TIAs) Sudden obstruction caused by an embolus ( EMBOLUS ) o Lodging in a cerebral artery o Localized unless multiple emboli are present Intracerebral hemorrhage ( HEMORRHAGE ) o Caused by rupture of a cerebral artery in patient with severe hypertension Effects are evident in both hemispheres. Complicated by secondary effects of bleeding Types of CVAs
ISCHEMIC ● thrombus ● embolus ● this patient can usually talk ● watch for mental health status changes HEMORRHAGIC ● hemorrhage ● bleeding in the brain ● this patient is going to unconscious ● likely to code STROKE RECOGNITION Ask the person to smile and stick their tongue out Ask the person to make a complete sentence Ask the person to raise both arms IF PERSON CANNOT PERFORM THESE THREE TASKS, CALL 911/SEEK MEDICAL ATTENTION INTRACRANIAL (CEREBRAL) ANEURYSM Localized weakness in the wall of an artery Cerebral aneurysms frequently multiple. o Usually at the points of bifurcation on the circle of Willis Berry aneurysms o Often aggravated by hypertension o Initially small and asymptomatic o Slow bleed causes vascular type headache. o Rupture leads to sudden fatal increase in ICP and death. Signs and symptoms o Loss of visual field or visual disturbances o Headache and photophobia o Intermittent periods of dysfunction o Nuchal rigidity caused by meningeal irritation o Vomiting, seizures, loss of consciousness in case of massive rupture; rapidly followed by death o Treatment Surgical treatment before rupture Antihypertensive drugs
Infections – BACTERIAL MENINGITIS ● Different age groups are susceptible to infection by different causative organisms. o May be secondary to other infections ● Children and young adults o Neisseria meningitis or meningococci o Classic meningitis pathogen o Frequently carried in the nasopharynx of asymptomatic carriers o Spread by respiratory droplets o Occurs more frequently in late winter and early spring ● Signs and symptoms o Sudden onset is common. o Severe headache o Back pain o Photophobia o Nuchal rigidity (neck stiffness) o Kernig sign ▪ Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.
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- Summer '16
- Traumatic brain injury, Blood sugar, brain tissue , Pathophysiology