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ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM

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

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ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM

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  1. ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM Exemplar Cerebrovascular Accident(CVA) Introduction to CVA / Stroke Prevention

  2. 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

  3. Cerebrovascular 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

  4. 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.

  5. Faculty animations from chtr 47 TIA

  6. Types of Strokes • Ischemic 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 rupturedaneurysm, arteriovenous malformation

  7. Faculty animation a fib cht 47

  8. Cerebrovascular Accident: Ischemic Thrombotic • Lumen of the blood vessels narrows (atherosclerosis) - becomes occluded -infarction occurs • Associated with HTN and Diabetes Mellitus

  9. Cerebrovascular Accident: Ischemic Embolic Stroke • Embolus lodges in/ occludes a cerebral artery • Infarction & cerebral edema develop • Emboli R/T : atrial fibrillation -MI -valvular prostheses • Severe symptoms occur rapidly– no collateral circulation • Any age group • Recurrence common if underlying cause not treated

  10. Cerebrovascular AccidentEmbolic Stroke

  11. Cerebrovascular Accident Hemorrhagic • Subarachnoid Hemorrhage -Intracranial bleeding -Increases with age and more common in women • Intracerebral Hemorrhage - rupture within the brain tissue • Aneurysm -abnormal blood vessel wall which ruptures

  12. Cerebrovascular AccidentHemorrhage Stroke Intracerebral Hemorrhage

  13. Cerebrovascular AccidentPopulations 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

  14. Pediatric Strokes • Populations 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

  15. Video on Pediatric Stroke • http://abcnews.go.com/Health/video/year-stroke-survivor-10139867

  16. Cerebrovascular AccidentRisk 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

  17. Prevention • Maintain healthy lifestyle -exercise -don’t smoke/alcohol in moderation • Diet -low sodium, low cholesterol • Control underlying medical problems -hypertension -diabetes mellitus -atrial fibrillation

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