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Cerebrovascular Disorders - Coggle Diagram
Cerebrovascular Disorders
Stroke
5th leading cause of death in U.S.
Often results in paralysis on one side of body
Because of rising number of elderly individuals,
incidence of stroke increasing
Risk for African Americans greater
Two Types
Ischemic (85%)
Thrombus or embolus
Leads to cerebral infarction
Causes
Cerebral arteriosclerosis
Carotid stenosis
Atrial fibrillation
Stasis of blood leads to clot formation
Most common in internal carotid and middle
cerebral artery
Hemorrhagic (15%)
Rupture of cerebral artery
Blood flows into brain, compresses and
displaces brain tissue
Blood causes vasospasm of adjacent blood
vessels
Blood released is toxic to surrounding cells
Anoxic encephalopathy
Lack of oxygen delivery causes decreased level of
consciousness
Cerebral edema may occur, putting pressure
on brain tissues
Pressure on brainstem causes alteration in HR,
breathing, pupil dilation
Cushing’s triad: pressure on brainstem
Bradypnea or irregular respirations
Bradycardia
Hypertension
If hemorrhage is large, hematoma and clot form; may expand in first 24 hours, worsening symptoms
Eventually, immune response and scar tissue
form
Transient ischemic attack (TIA)
Ischemic injury, "mini-stroke" (inaccurate label)
Temporary and resolves
20%–25% of TIA’s progress to stroke
Neurological changes may go unnoticed by patient
Observable by bystanders
TIA may be resolved by time medical help is received
Interview of patient and observers is key
Lacunar infarct
Small infarcts in brain due to occlusion of tiny
blood vessels
SAH and VBI
Subarachnoid hemorrhage (SAH)
Sudden onset (“worst headache ever,”
“thunderclap headache”)
Presents differently than most hemorrhagic
strokes
Vertebrobasilar insufficiency (VBI)
Ischemia of vertebrobasilar circulation
Dizziness, vertigo, headache
Ischemic Stroke tPA Treatment
Intravenous thrombolysis
Rt-PA: recombinant tissue-type plasminogen
activator
"Clot buster"
Must be used within 4 hours of the
beginning of the stroke symptoms
Ischemic Stroke Treatment
Aspirin or another antiplatelet drug
Surgical thrombectomy for eligible
candidates
Rehabilitation
1st 4 weeks post-stroke especially important to
regain function
Treatment for Cerebral Hemorrhage
Hemodynamic stabilization
Intubation and BP reduction
Manage cerebral edema
Surgical treatment