Acquired language - Class 1

  What is a cerebral vascular accident? What are the two major types?

  1.   What is the ditterence between a hemorrhage and an aneurysm?

3. What is a tumor?


Causation:

Cerebral Vascular Acadent

- Disrupts blood flow to the brain.

Several types (Ischemic & hemorrhagic)I

Ischemic :

"occlusion of an artery, usually the MCA of the carotid causing a reduction or cessation of blood flow-

•Caused by atherosclerosis, proliferation of cells, high cholesterol


2 major types of Ischemic Stroke


1, Thrombosis

  •   Accumulation ot platelets and fatty plaques on the vessel wall at the site of the occlusion

  • Increases in severity over time

  •   High among peopre with diabetes mellitus and hypertension

  • TIA: transient ischemic attack (mini stroke), (frequent signal ot disruption of blood flow

  • blurred vision, numbness, weakress i speech difficulty,

  • Lasts less than one hour. Completed within 24 hours

  •   Thrembectony: surgical thrombectomy is a type of surgery to remove a blood clot from inside an artery or vein to avoid permanent blockage in the vein or artery.


•A thrombectomy can be used to treat a stroke .

Risks:

  •   Bruising at the puncture sith

  •   Blood cot could travel deeper into the artery or vein

• Stroke

Thrombolic stroke: regular suitcase blocking the highway

2. Embolism (traveling suitcasel

• Platelets and fatty plaque break off a vessel and travel until they become stuck in a smaller artery

  • may go into the heart, or to the brain (no warning signs)

Embolic stroke: traveling suitcase, travels to a smaller artery


Infarction: when metabolism is prohibited for 2 min the result is death (necrosis) of (neural tissue. = infarct

• Damaged tissue softens and liquefies, removed by astroglial cell, leaves a dark space in the brain

Glosis: waste removal, Leaves a cavity in the cortex.


Hemorrhage (volcano)

-associated with hypertension, aneurysm, or AvM.

Accompanies a TBI

" Occurs due to a rupture ot a cerebral blood vessel: Volcano

  •   NO blood flow above the rupture

  •   Types of Hemorrhuge:

1. Intracerebral hemorrhage: invades the regions of the thalamus, internal capsule, and lenticular nuclei

- loss of consciousness, increase in blood pressure

  • during physical ucturty, or emotional stress

- Highest risk for a hemorrhage circle of Willis, basilar artery

2. Subarachnoid: in the pia-arachnoid space Surrounding the brain. Can be caused by a ruptured aneurysm

  • In between the duramatta and brain (padding of the brain)

Aneurysm: dialated blood vessel that stretches and Weakens the vessel wall caused by sudden exertion

- Goes from normal artery → ruptured aneurysm (volcano)

Arteriovenous Maiformation (AUM): a tangle of blood vessels in the brain or on its surface that diverts blood from the arteries to the veins)

- usually less damaging than aneurysm

Hematoma: accumulation of blood caused by a hemorrhage.

Tumors: abnormal mass of tissue

Signs: headache, precipitated by stopping ,straining, exercise

  •   May be malignant (cancerous or benign (non cancerous)

  •   Gliomas: glial cell tumors = trequent form of brain tumor

  •   Astrocytoma: benign, slow growing tumor.

  •   Glioblastoma multiforme: malignant and fast growing tumor

  •   Meningiona: benign tumor that arises from the meninges

  •   Metastic tumor i arise from elsewtere in the body, travel to the brain via the blood supply, or lymphatic system.

1. CVA: disrupts bloud flow to the brain. Ischemic and hemorrhage.

  1. Hemorrhage: a rupture in a vessel
    Aneurysm: blood vessel that stretches

  2.   Abnormal mass of tissue. Several types of tumors
    Strokee Risk Factas

Rist factors

- Hypertension - High blood pressure

  •   Heart disease

  •   previous TIt's

  •   Hyperlipidemiss fat in arteries including cholesterol

- Heart attack

* High alcohol Consumption

- Obesity Excessive Weight

- Diabetes

  • Smoking

  •   Family History

*-Stress

Warning Signs

  •   numbness or weakness on one side of the body

  •   trouble speaking - trouble understanding

  • trable walking I staying balanced

Recognizing a stroke

S: smile

T: talk/Speak a sentence

R: Raise both arms

*ast person to 'stick' out their tongue


TPA: Tissue Plasminogen Activator

Protein that reduces the blood clot

  • treats only thrombotic or embolic stroke

  • given within 3hrs of their first symptoms

  • cannot have a hemorrherge

TNK: Tenecteplase

  • similar to TPA but easier to administor with a single quick injection, more efficient in dissolving the clots

  • also within 3 hos

NIH Stroke Scale

- given 2hrs post, 24hrs post, 7-10 day later,

3 months later.

- Used when a person has a stroke, need to determine

level of consciousness, commands, Gaze

High density: blood

Low density: blood but in a smaller area


Diagnostic Techniques

Cerebral Angiogram: evaluates cerebral vascular structures and is used for arterialivenous, and lymphatic circulation studies

Used to diagnose:

  •   Thrombosis

  •   Hemorrhages

  •   Embolist

  •   built up of fat

- AVM

  • Antheroscierosis


  •   A radiopaque contrast substance is usually injected into the femoral artery side of quad

  •   Sent through a catheter

  •   Will tale X-rays at various angles

Some risks: Damaged to blood infection, bruising, infection

* less than 1% of cases, stroke can occur:

Anaphylaxis: hard time breathing

• Use an iodine as a contrast material, inject into the vessel by needle (catheter through femoral Lcheck for infection (white blood rount: cheite for infection)

* anybody wlan increase of white blood count ot over 10.5 has an increase for intection i bed rest for a few hours is required

Difference between MRI and CT

40

CT: Cat Scan: an x-ray machine hooked up to a computer

  •   Lay patient flat

  •   uses pencil thin beam to take cross-Sectional images

  •   beam rotates around patients body

  •   uses radiation to tate images, quicte, to Keep doses low and safe

  •   5 min

  •   good for organs in the body, bony detail

  • MRI: Magnetic resonance imaging simages the water molecules in the body

  •   Lay patient down, place shoulder into coil and between the radiotrequency, strong magnetic field, and coil (acts as antena)- produce images

  • • 30 min

  •   No radiation, uses strong magnetic field w/radiofrequency

  •   Specialty is soft tissue
    Computed Tomography

  •   Multiple x-rays of the brain, taken at different angles

  •   Produce cross-sectional images of the brain

  •   100 times more sensitive than conventional radiography

  •   examine brain in thin slices (1 or 2mm. thick)

Adema: Swelling

  •   Can see tumor masses, infarctions, bone displacement, and accumulations of fivid may be detected Magnetic Resonance Imaging (MRI)

  •   produce a 3-dimensional image of the brain

  •   Each water molecule in our body contains 2 hydrogen nuclei

  •   powertul magnets are used to produre a strong magnetic field that forces the hydrogen atoms of the brain tissues to align in a single plane

  •   Since gray matter contains more water than white matter, there is a remantable difference between the images of each

  •   Because many patients experience claustrophobia during MRI about 15% will require on anxiolytic

Positron Emission Tomography (PET)

  •   Assesses physiological changes in the brain cells

  •   Use computerized radiographic technique that will use radioactive substances to examine metabolic activity of various structures

  •   Radionuclide and glucose solution injected via IV

  •   Shows how your organé tissue worke at cellular level

  •   Generates color coded images

  •   Allows study of brain physiology that shows mental e sensorimotor functions

  •   Evaluates functions of organs (small radiation)
    Electroencephalography (EEG).

  •   45-90 min

  •   Examines altered level of consciousness (such as sleep)

  •   Helpful in diagnosing epilepsy, sleep disorders, brain stem

  • Records electrical activity of your brain

  •   Electrodes are placed on the scalp for electrical recording