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CVA/Stroke

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by

Kyla May

on 19 June 2013

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Transcript of CVA/Stroke

Cerebral Vascular Accident (CVA/Stroke)
By Kyla May

Definition
A stroke is a interruption or severely reduced supply of blood to the brain depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die. (1)
Causes
Atherosclerosis
Carotid Artery Disease
Atrial Fibrillation
Lesions caused by atherosclerosis
Sudden bleeding in the brain
High blood pressure
Aneurisms
Arteriovenous malformations
Facts
Approx. 130,000 people die from stroke in the US every year
More than 795,000 people have a stroke each year in the US
610,000 are first or new strokes
$38.6 billion per year
Leading cause of disability
34% of strokes occur in people under the age of 65
(5)
Cerebellar Ataxia
References
1. http://www.mayoclinic.com/health/stroke/DS00150
2. http://www.mayoclinic.com/health/transient-ischemic-attack/DS00220
3. http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/atrisk.html
4. http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/causes.html
5. http://www.cdc.gov/stroke/facts.htm
6. http://www.strokeassociation.org/STROKEORG/AboutStroke/UnderstandingRisk/Understanding-Stroke-Risk_UCM_308539_SubHomePage.jsp
7. http://www.strokecenter.org/patients/about-stroke/stroke-statistics/
8. http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots_UCM_310939_Article.jsp
9. http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds_UCM_310940_Article.jsp
10. http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/TIA/TIA-Transient-Ischemic-Attack_UCM_310942_Article.jsp
11. http://www.stroke.org/site/DocServer/NSA_complete_guide.pdf
12. http://www.strokecenter.org/professionals/brain-anatomy/blood-vessels-of-the-brain/
13. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002372/
14. http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/treatment.html
15. Lescher, Penelope J. "Pathology for the Physical Therapist Assistant." Philadelphia: F.A. Davis Company, 2011. 312-313
16. http://strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/@sta/documents/image/ucm_452104.jpg
Risk Factors
High blood pressure
Smoking
Diabetes
Heart diseases
Coronary artery disease
Cardiomyopathy
Heart failure
A-Fib
Aneurisms
AVM (arteriovenous malformation)
Age
Gender
Race/Ethnicity
Family history
Alcohol and illegal drugs
Obesity
Unhealthy cholesterol levels
Unhealthy diet
Lack of physical activity
Stress and depression
Sickle cell anemia
Vasculitis
3 & 4
African Americans
Highest at risk due to the high incidence of obesity, diabetes, and high blood pressure
Hispanic Americans fall between African Americans and Caucasions
55,000 more women have strokes than men
Highest death rates due to stroke occur in the southeastern US
(5,6)
U.S. Stroke Deaths 35+, 2000-2006 by county (7)
Types
Ischemic
Hemorrhage
TIA
Occur as a result of an obstruction withing a blood vessel supplying blood to the brain (8)
87% of strokes are ischemic
Results from a weakened vessel that ruptures and bleeds into the surrounding brain
Intracerebral - within the brain
Subarachnoid - on the surface of the brain
13% of strokes are Hemorrhage
(9)
Mini stroke - Warning stroke
Caused by a clot with the difference being the blockage is transient
Right-Hemisphere Stroke
Right side of the brain controls:
Movement of the left side of the body
Analytical and perceptual tasks
Connecting parts to wholes
Common side effects
Misjudge distances (leading to falls or being unable to pick up an object)
Difficulty knowing right side up from upside down when reading
Impulsive
Denial of condition
Left-sided neglect
Short term memory loss
Pathological laughing/weeping
Outbursts
(11)
Left Hemisphere Stroke
Left side of the brain controls
Right side of body
Speech and language abilities
Common side effects
Cautious
Difficulties communicating
Processing in a sequential manner
Anxious and frustrated
Cerebellar Stroke
Cerebellum controls
Reflexes
Balance
Coordination
Common Side effects
Abnormal reflexes of the head and torso
Coordination problems
Balance problems
Dizziness
Nausea
Vomiting
Brain Stem Stroke
Brain stem controls
Involuntary functions
Eye movement
Hearing
Speech
Swallowing
Common side effects
Paralysis
Death
(11)
(11)
(11)
Major blood vessels of the brain
Right and Left Carotid arteries
External supply the face and scalp
Internal supply the anterior 3/5 of cerebrum except for parts of the emporal and occipital lobes
Vertbrobasilar arteries
Posterior 2/5 of the cerebrum
Part of the cerebellum
Brain stem
Circle of Willis
Anterior Cerebral Artery
Middle Cerebral Artery (Most often occluded)
Posterior Cerebral Artery
Lenticulostriate Arteries
Vertebral Arteries
(12)
Uncoordinated muscle movement due to disease or injury to the cerebellum.
Symptoms
Movement from side to side , back to front or both while sitting
Swaying in the arms during movement
Dysarthria (clumsy speech pattern)
Nystagmus (repetitive eye movements)
Uncoordinated eye movements
Walking problems (unsteady gait)
(13)
Treatments
Medical Ischemic
Medicines
tPA (tissue plaminogen activator) if given within 4 hours of the start of symptoms can break up blood clots
Antiplatelets
Anticoagulants (blood thinners)
Medical procedures
Carotid endarterectomy or carotid artery angioplasty
Intra-arterial thrombolysis
MERCI (mechanical clot removal in cerebral ischemia
Pneumbra System
(14)
Medical Hemorrhage
Medicines
Blood pressure lowering
Medical procedures for Aneurysm
Aneurysm Clipping
Coil Embolization
Medical procedures for AVM
AVM removal
Injection to the blood vessels to block blood flow
Radiation to shrink blood vessels
(14)
Treatments Cont.
Physical Therapy
Treatment starts within 24-48 hours after stabilization
Bed mobility
ROM exercises of affected limbs
Active exercises for unaffected limbs
Transfers from bed to chair
Ambulation
Use of assistive devices
Functional tasks
Postural and balance work
Perception/Proprioception
(15)
Treatments Cont.
Innovative Technology
Saebo (saebo.com)
Tailwind (tailwindtherapy.com)
LiteGait (litegait.com)
Biomove (biomove.com)
Meditouch (.meditouch.co.il)
Mobility Power System (myomo.com)
Time is everything
Patients who receive treatment within 3 hours of the first sign of a stroke are 33% more likely to recover from their stroke with little or no disability after 3 months.
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