LESSON 2: PART 3 - CVA (STROKE)

Transient ischemic attack (TIA)

Symptoms of focal neurological deficit may last for only a few minutes or for several hours, but by definition do not last longer than 24 hours.

Transient ischemic attack (TIA)

After the attack is over there is no evidence of residual brain damage or permanent neurological dysfunction.

Deteriorating stroke

is used to refer to the patient whose neurological status deteriorates after admission to the hospital.

Young stroke

is used to describe a stroke affecting persons younger than age 45.

• perinatal arterial ischemic stroke

• sickle cell disease

• congenital HD

• thrombophlebitis

• trauma

Causes of stroke in children include:

Cerebral blood flow (CBF)

Progressive narrowing secondary to atherosclerosis decreases blood flow.

Autoregulatory mechanisms

These mechanisms provide homeostatic balance, counteracting fluctuations in systolic blood pressure while maintaining a normal flow of 50 to 60 mL per 100g of brain tissue per minute.

Cerebral flow

represents approximately 17% of available cardiac output.

Vasodilation

produced when fall in pH.

Acidity

a fall in pH.

Alkalinity

a rise in pH.

Internal carotid artery

begins at the bifurcation of the common carotid artery and ascends in the deep portions of the neck to the carotid canal.

Anterior communicating artery

communicates with the anterior cerebral arteries of either side, giving rise to the rostral(front) portion of the circle of Willis.

Vertebral artery

arises as a branch off the subclavian artery.

Vertebral artery

It enters the vertebral foramen of the sixth cervical vertebra and travels through the foramina of the transverse processes of the upper six cervical vertebrae to the foramen magnum and into the brain.

Basilar artery

bifurcates to form the posterior cerebral arteries and the posterior portion of the circle of Willis.

Posterior communicating arteries

connect the posterior cerebral arteries with the internal carotid arteries and complete the circle of Willis.

Anterior cerebral artery (ACA)

is the first and smaller of two terminal branches of the internal carotid artery.

Anterior cerebral artery (ACA)

It supplies the medial aspect of the cerebral hemisphere (frontal and parietal lobes) and subcortical structures, including the basal ganglia (anterior internal capsule, inferior caudate nucleus), anterior fornix, and anterior four-fifths of the corpus callosum.

Anterior Cerebral Artery Syndrome

contralateral hemiparesis and sensory loss with greater involvement of the lower extremity (LE) than the upper extremity (UE) because the somatotopic organization of the medial aspect of the cortex includes the functional area for the LE.