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ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM

Cerebrovascular accidents (CVAs), commonly known as strokes, are a major health concern, causing approximately 800,000 cases annually in the USA. They result from interrupted blood flow to the brain, leading to ischemia or hemorrhage. CVAs are the third most common cause of death and the leading cause of disability. This overview outlines the types of strokes, including ischemic and hemorrhagic, as well as risk factors such as age, race, and medical history. Prevention strategies emphasize lifestyle changes, early medical intervention, and managing underlying health conditions.

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ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM

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  1. ALTERATIONS IN THE CENTRAL NERVOUS SYSTEM Exemplar Cerebrovascular Accident(CVA) Introduction to CVA / Stroke Prevention

  2. 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 doesn’t store oxygen/ glucose and needs a constant flow of blood

  3. Cerebrovascular Accident • Approximately 800,000 in USA annually • (425,000=F; 370,000=M) * • Third most common cause of death • #1 leading cause of disability • Physical, cognitive, emotional, & financial impact • *http://www.stroke.org/site/News2?page=NewsArticle&id=9015&news_iv_ctrl=1222

  4. 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.

  5. Faculty animations from chtr 47 TIA

  6. 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 rupturedaneurysm, arteriovenous malformation

  7. Faculty animation a fib cht 47

  8. Cerebrovascular Accident: Ischemic Thrombotic • Lumen of the blood vessels narrows (atherosclerosis) - becomes occluded -infarction occurs • Associated with HTN and Diabetes Mellitus

  9. 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

  10. Cerebrovascular AccidentEmbolic Stroke

  11. 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

  12. Cerebrovascular AccidentHemorrhage Stroke Intracerebral Hemorrhage

  13. Cerebrovascular AccidentPopulations at Risk • Age – Occurrence doubles each decade >55 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?pagename=RISK

  14. Pediatric Strokes • Populations at Risk M>F; African American>White, Asian • Medical Hx -sickle cell disease -heart disease (congenital or acquired) Signs & Symptoms -infant may have one sided seizure -older child has weakness/numbness

  15. Video on Pediatric Stroke • http://abcnews.go.com/Health/video/year-stroke-survivor-10139867

  16. 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

  17. Prevention • Maintain healthy lifestyle -exercise -don’t smoke/alcohol in moderation • Diet -low sodium, low cholesterol • Control underlying medical problems -hypertension -diabetes mellitus -atrial fibrillation

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