Lecture Notes: Cerebrovascular Disorders and Strokes

Overview of Cerebrovascular Disorders

• Cerebrovascular disorder: Functional abnormality of CNS due to disrupted blood supply to the brain.
• Stroke: Most common cerebrovascular disorder; interruption of blood supply in the brain.
  • Often called a "brain attack."
  • Types: Ischemic, Hemorrhagic, Transient Ischemic Attack (TIA).

Types of Strokes

1. Ischemic Stroke

• Cause: Blockage of cerebral artery due to a thrombus or embolus.
• Types:
  • Embolic Stroke: Dislodged clot travels to the brain.
  • Thrombotic Stroke: Clot forms within the artery.
• Effect: Causes ischemic tissue and brain cell death.

2. Hemorrhagic Stroke

• Cause: Ruptured vessel causes bleeding into brain tissue.
• Common Causes: Aneurysm, high blood pressure, aging blood vessels.

3. Transient Ischemic Attack (TIA)

• Also known as a “mini-stroke.”
• Symptoms: Temporary, lasting minutes to hours; warning sign for future serious stroke.

Stroke Symptoms and Effects

• Symptoms: Vary depending on the affected side of the brain.
  • Right Brain Stroke:
    • Affects left side of the body.
    • Symptoms: Impaired creativity, attention, emotions; left-side neglect.
  • Left Brain Stroke:
    • Affects right side of the body.
    • Symptoms: Aphasia, impaired math skills, right-side neglect.

Risk Factors and Prevention

• Acronym: "Strokes Happen" to remember risk factors.
• Types:
  • Modifiable: Lifestyle changes (e.g., exercise, diet).
  • Non-modifiable: Age, genetics.
• Prevention: Control hypertension, encourage healthy diet, smoking cessation.

Recognizing a Stroke: BE FAST

• Balance
• Eyes
• Face
• Arms
• Speech
• Time (call 911 immediately)

Diagnostic and Treatment Approaches

• Initial Tests: Non-contrast CT, EKG, ultrasound, MRI.
• Treatment for Ischemic Stroke:
  • Medication: TPA (tissue plasminogen activator); criteria: within 3 hours of symptoms, specific lab values.
  • Other Medications: Aspirin, Heparin, etc.
• Procedures:
  • Endovascular techniques: Catheter use for clot disruption.
  • Carotid Endarterectomy: Plaque removal from carotid artery.

Nursing and Rehabilitation

• Nursing Assessment: Monitor vital signs, neuro checks, lab values.
• Rehabilitation Goals:
  • Improve mobility and self-care abilities.
  • Prevent complications like aspiration and ulcers.
  • Strengthen communication and family support.
• Home Care: Education, support groups, resources coordination.

Conclusion

• Importance of early stroke recognition and treatment.
• Emphasis on prevention and the role of lifestyle changes.
• Encourage further review in textbooks, especially charts and tables for detailed comparisons and data.