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Transcript of Stroke
Cerebral Vascular Accident
By: Carolyn Stewart
= loss of brain function due to a disturbance in blood supply to the brain
The effects of stroke were first described as early as the 2nd millennium BC.
Hippocrates described early cases of stroke as apoplexy, meaning, "struck down with violence."
1599- "Stroke" and "apoplexy" used interchangeably
1658- Jacob Wepfer discovers that patients dying of apoplexy also have bleeding in the brain.
In the mid-nineteenth century, Rudolph Virchow described the mechanism of thromboembolism.
1927- "Cerebral Vascular Accident"
1990- "Brain Attack"
"Neurological deficit of cerebrovascular cause that persists beyond 24 hours, or is interrupted by death within 24 hours."
Stroke kills nearly 130,000 Americans each year, accounting for 1 out of every 19 deaths in the U.S.
795,000 strokes occur each year.
Stokes kill one person every 4 minutes.
WHO estimates that
strokes occur each year.
Of these, 5 million result in death and another 5 million result in permanent disability.
Stroke incidence has decreased in developed countries and increased in developing countries.
Decreased blood flow to the brain, caused by:
Bleeding of the brain's blood vessels:
Does not have any outward symptoms.
The thrombus (blood clot) usually forms around atherosclerotic plaques.
A particle or debris, originating from elsewhere in the body, travels through the bloodstream and lodges in an artery of the brain.
Reduction of global bloodflow; all parts of the brain may be affected.
Hematoma enlarges until pressure from surrounding tissues limit its growth, or until it decompresses by emptying into the ventricular system, cerebrospinal fluid, or the pial system.
Blockage of the involved artery develops gradually.
Onset of symptoms is relatively slow.
Large or small vessels may be affected.
Blockage develops rapidly.
Onset of symptoms occurs very quickly.
Most commonly due to heart failure, cardiac arrest, arrhythmias, or reduced cardiac output.
Hypertension, vascular malformations, trauma, bleeding disorders, and illicit drug use.
44% after 30 days
Patients are typically unaware that they have suffered a stroke.
Higher risk of Ischemic or major strokes in the future.
Silent strokes occur 5x more often than symptomatic strokes.
Time is of the Essence
Cincinatti Prehospital Stroke Scale
Los Angeles Prehospital Stroke Screen
Dependent on which area of the brain is affected:
Central Nervous System Pathways
12 Cranial Nerves
Loss of Consciousness
75% of stroke survivors experience long-term disability.
"Time is Brain!"
Blood Cholesterol Levels
Illicit Drug Use
Previous prevention has centered around the use of anticoagulant drugs such as Aspirin and Warfarin.
Angioplasty and Stenting
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Ward, J, Sugar, T, Standeven, J, Engsberg, J. "Stroke Survivor Gait Adaptation and Performance After Training on a Powered Ankle Foot Orthosis". 2010 IEEE International Conference on Robotics and Automation Anchorage Convention District May 3-8, 2010, Anchorage, Alaska, USA. Retrieved 2014-9-2014.