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ESCASIO, MARK RYAN PATRICK S.
GRANDE, JOSELITO P.
ISAAC, MIRA P.
REYES, LEONORA
Cerebrovascular accident is the term that refers to any functional abnormality of the
Central Nervous System that occurs when the normal blood supply to the brain is
disrupted, as by a blood clot or a ruptured blood vessel, and vital brain tissue dies.
Cerebrovascular accident is commonly called Strokes.
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blockage in the thrombus (clot) that has built up on the wall
of the brain artery.
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blockage by an embolus (usually a clot) swept into the artery in
the brain.
4 i Rupture of a blood vessel and bleeding within or over the surface of
the brain.
Thrombosis and embolism both lead to cessation of blood supply to part of the brain thus
to infarction (tissue death). Rupture of a blood vessel in or near the brain may cause an
intracerebral hemorrhage or subarachnoid hemorrhage.
The symptoms of a stroke usually develop over minutes or hours occasionally over several
days. Depending on the site, cause and extent of damage, any or all of the symptoms at right
may be present, in any degree of severity. The more serious cases lead to rapid loss of
consciousness, coma, and death or to severe physical or mental handicap.
Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do
not progress further. The symptoms depend on the area of the brain affected. The more
extensive the area of brain affected, the more functions that are likely to be lost. Some
forms of stroke can cause additional symptoms. For example, in intracranial hemorrhage,
the affected area may compress other structures. Most forms of stroke are not associated
with headache, apart from subarachnoid hemorrhage and cerebral venous thrombosis and
occasionally intracerebral hemorrhage.
If the area of the brain affected contains one of the three prominent central nervous system
pathwaysȄthe spinothalamic tract, corticospinal tract, and dorsal column (medial
lemniscus), symptoms may include:
If the is involved, the CNS pathways can again be affected, but also can
produce the following symptoms:
4 trouble walking
4 altered movement coordination
4 vertigo and or disequilibrium
Loss of consciousness, headache, and vomiting usually occurs more often in hemorrhagic
stroke than in thrombosis because of the increased intracranial pressure from the leaking
blood compressing the brain.
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Head CT showing deep intracerebral hemorrhage due to bleeding within the cerebellum,
approximately 30 hours old.
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sensitivity= 89%
specificity= 100%
4 MRI scan
sensitivity= 81%
specificity= 100%
For the assessment of stable stroke, nuclear medicine scans SPECT and PET/CT may be
helpful. SPECT documents cerebral blood flow and PET with FDG isotope the metabolic
activity of the neurons.
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When a stroke has been diagnosed, various other studies may be performed to determine
the underlying etiology. With the current treatment and diagnosis options available, it is of
particular importance to determine whether there is a peripheral source of emboli. Test
selection may vary, since the cause of stroke varies with age, comorbidity and the clinical
presentation. Commonly used techniques include:
4 an ultrasound/doppler study of the carotid arteries (to detect carotid stenosis) or
dissection of the precerebral arteries
4 an electrocardiogram (ECG) and echocardiogram (to identify arrhythmias and
resultant clots in the heart which may spread to the brain vessels through the
bloodstream)
4 a Holter monitor study to identify intermittent arrhythmias
4 an angiogram of the cerebral vasculature (if a bleed is thought to have originated
from an aneurysm or arteriovenous malformation) blood tests to determine
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