Left Hemisphere
- All about the Past and future (Linear)
- Takes picture of of the present and integrates it into past and future
- Thinks in words
- “recognizes self”
Right Hemisphere
- Deals with the present moment
- Smells, tastes, touch connected through consciousness of right hemisphere - Parallel process
Stroke Costs on Healthcare
- Care and productivity lost for stroke survivors cost an estimated $74 billion in the US during 2008
Stroke Prevalence
-Which race has highest stroke occurrence
- American Indian
then black
Transient Ischemic Attack
-Golden window for treatment
- 4 hrs from the time symptoms began
Transient Ischemic Attack (TIA)
Vs.
CVA
- Results from a brief or partial interruption of blood flow
- CVA is prolonged or complete blockage/hemmorhage
Hemorrhagic stroke
- When blood vessel bursts in the brain
2. 1/10 strokes are hemorrhagic but they are more deadly than ischemic strokes
Ischemic Stroke
-Thrombotic Stroke
- Blockage occurs right in an artery in the brain
- less common than embolic stroke
Ischemic Stroke
-Embolic Stroke
- Occurs when blood clots break off from the heart or from an artery that carries blood to the brain.
- More common than thrombotic strokes
Ischemic Vs Hemorrhagic Strokes
-Statistics
- 9 of every 10 strokes are ischemic
CVA
-Risk Factors
- Dehydration
- Blood becomes more viscous TEST - Atrial Fibrillation
Considerations for Pt’s w/ New Onset of Atrial Fibrillation
- A patient with new case of A-fib needs to be on coumadin
Ischemic Stroke
-Thrombotic Stroke is Caused by?
- Results from atherosclerosis and inflammatory disease process that damage arterial walls
Ischemic Stroke
-Embolic
- Fragments that break from a thrombus formed outside the brain or in the heart, aorta, or common carotid artery
- Usually middle cerebral artery affected **
Lacunar strokes
- Very small strokes that affect memory
2. Caused by occlusion of a single deep perforating artery that supplies small penetrating subcortical vessels
Risk Factor for Embolic Stroke
- Atrial Fibrillation
Hemorrhagic Stroke
- Intracranial hemorrhage r/t HTN, ruptured aneurysms or vascular malformations
- bleed into a tumor, or intake of:
- Anticoagulants or clotting disorders, head trauma, or illicit drug use
Cerebral Infarction Pathophysiology
-Thrombi/embolus
- Abrupt vascular occlusion
Cerebral Infarction Pathophysiology
-Atheroma
- Gradual vessel occlusion
Cerebral Infarction Pathophysiology
-Ruptured aneurism
- Hemorrhagic
- Primary cause hypertension
Cerebral Infarctions
-What happens at 6-12 hrs
- Affected area becomes slightly discolored and softens
Cerebral Infarctions
-What happens at 48-72 hrs
- Necrosis
- Swelling around insult
- Mushy disintegration
Cerebral Infarctions
-What happens at 2 weeks
- Necrosis resolves leaving a cavity (a hole)
1st thing to do when Stroke is Suspected
- CT scan to differentiate between hemorrhagic and ischemic stroke
