ALTERATIONS%20IN%20THE%20CENTRAL%20NERVOUS%20SYSTEM

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ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM

• Exemplar
• Cerebrovascular Accident(CVA)
• Introduction to CVA / Stroke
• Prevention

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Stroke (Brain Attack)

• Definition
• -Blood flow interrupted to an area of the
  brain
• -Ischemia to the part of the brain
• -Bleeding into brain tissue
• -The brain doesnt store oxygen/ glucose and
  needs a constant flow of blood

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Cerebrovascular Accident

• Approximately 800,000 in USA annually
• (425,000F 370,000M)
• Third most common cause of death
• 1 leading cause of disability
• Physical, cognitive, emotional, financial
  impact
• http//www.stroke.org/site/News2?pageNewsArticle
  id9015news_iv_ctrl1222

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Transient Ischemic Attack (TIA)

• Temporary focal loss of neurologic function
• Caused by ischemia of one of the vascular areas
  of the brain
• Most resolve within 3 hours
• Difference of TIA vs. CVA is infarction
• Easton,JD, Saver,JL, Albers, GW, et al.
  Definition and evaluation of transient ischemic
  attack.Stroke. 2009 40(6)2276-2293.

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• Faculty animations from chtr 47 TIA

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Types of Strokes

• Ischemic stroke (87)
• -Thrombotic stroke atherosclerosis of
  blood vessel wall
• -Embolic stroke dislodged clot from
  other area of body
• Hemorrhagic stroke (13)
• Bleeding into brain tissue r/t ruptured
  aneurysm, arteriovenous malformation

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• Faculty animation a fib cht 47

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Cerebrovascular Accident Ischemic
Thrombotic

• Lumen of the blood vessels narrows
• (atherosclerosis)
• - becomes occluded
• -infarction occurs
• Associated with HTN and Diabetes Mellitus

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Cerebrovascular Accident Ischemic Embolic
Stroke

• Embolus lodges in/ occludes a cerebral artery
• Infarction cerebral edema develop
• Emboli R/T atrial fibrillation
• -MI
• -valvular prostheses
• Severe symptoms occur rapidly no collateral
  circulation
• Any age group
• Recurrence common if underlying cause not treated

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Cerebrovascular AccidentEmbolic Stroke
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Cerebrovascular Accident Hemorrhagic

• Subarachnoid Hemorrhage
• -Intracranial bleeding
• -Increases with age and more
  common in women
• Intracerebral Hemorrhage
• - rupture within the brain tissue
• Aneurysm
• -abnormal blood vessel wall which
  ruptures

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Cerebrovascular AccidentHemorrhage Stroke
Intracerebral Hemorrhage
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Cerebrovascular AccidentPopulations at Risk

• Age Occurrence doubles each decade gt55 years
• Gender Almost equal for men women
• Race African Americans, Hispanics, Native
  Americans, Asian Americans -- higher incidence
• Heredity family history, prior transient
  ischemic attack, or prior stroke increases risk
• http//www.stroke.org/site/PageServer?pagenameRIS
  K

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Pediatric Strokes

• Populations at Risk
• MgtF African AmericangtWhite, Asian
• Medical Hx
• -sickle cell disease
• -heart disease (congenital or acquired)
• Signs Symptoms
• -infant may have one sided seizure
• -older child has weakness/numbness

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Video on Pediatric Stroke

• http//abcnews.go.com/Health/video/year-stroke-sur
  vivor-10139867

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Cerebrovascular AccidentRisk Factors

• Controllable Risks with Medical Treatment
  Lifestyle Changes
• High blood pressure
  DiabetesCigarette smoking
  TIA (Aspirin)High blood cholesterol
  ObesityHeart Disease
  Atrial fibrillation
• Oral contraceptive use Physical
  inactivity
• Sickle cell disease
  Asymptomatic carotid Hypercoagulability stenosis

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Prevention

• Maintain healthy lifestyle
• -exercise
• -dont smoke/alcohol in moderation
• Diet
• -low sodium, low cholesterol
• Control underlying medical problems
• -hypertension
• -diabetes mellitus
• -atrial fibrillation