Cerebrovascular Accident (Stroke)

1. Definition of "cerebrovascular accident."

1. It is loss of brain function resulting from a disruption of blood flow to part of the brain.

2. There are four basic causes of cerebral vascular accidents.

1. Thrombus, which is a blood clot that forms in a brain artery and blocks blood flow.

2. Embolus, which is a wandering blood clot or other material carried in the circulatory system that lodges in the brain.

3. Compression, which is a pinching of an artery by a tumor or swelling.

4. Hemorrhage or bleeding from a brain artery into surrounding tissue.

3. Recovery from a cerebrovascular accident depends on the area of the brain involved and the extent of damage done.

4. Transient ischemic attacks, which are temporary impairment of blood flow to the brain, may precede a stroke.

2. Factors that increase the risk of cerebrovascular accident.

1. Noncontrollable risk factors.

1. Advancing age.

2. Positive family history.

3. Race (blacks have a higher incidence than whites).

4. Sex (men have a higher incidence than women).

5. Prior stroke.

6. History of diabetes, cardiac, disease, and renal disease.

2. Controllable risk factors.

1. Hypertension.

2. Obesity.

3. Use of oral contraceptives.

4. Smoking.

5. Diet high in cholesterol.

3. Warning signs of a stroke.

1. Sudden temporary weakness or numbness on one side of the body.

2. Temporary loss of speech, or slurred speech.

3. Unexplained dizziness, unsteadiness, or falls.

4. Temporary loss of vision or blurred vision.

5. Change in level of consciousness.

4. Possible effects of a stroke.

1. Paralysis or weakness on one side of the body.

2. Difficulty with speech and language.

3. Memory loss and confusion.

4. Urine and fecal incontinence.

5. Emotional lability.

6. Difficulty swallowing.

7. Visual deficits.

5. Measures to prevent a stroke.

1. Prevent atherosclerosis.

1. Achieve and maintain ideal weight. (Provide "Weight Reduction" handout.)

2. Avoid a diet high in cholesterol. (Provide "Decrease Cholesterol" handout.)

2. Decrease or avoid alcohol consumption.

3. Monitor and control diabetes, high blood pressure, or other diseases.

4. Avoid oral contraceptives.

6. Measures important in treatment or management of a stroke.

1. Early rehabilitation program including physical therapy, speech therapy, and occupational therapy.

2. Active and passive range of motion exercises.

3. Prevention of skin breakdown.

4. Adequate nutrition.

5. Bowel and bladder training.

6. Emotional support (support groups, counseling, etc.).

7. Safe environment (grab bars, handrails, safe floor surfaces, ramps, etc.). (Refer to Safety/Potential for Injury to the Elderly Teaching Guide.)

8. Self-help devices to encourage independence. (Provide "Self-Help" handout.)

7. Possible complications of cerebrovascular accident.

1. Skin breakdown.

2. Bowel and bladder difficulties.

3. Thrombophlebitis.

4. Malnutrition.

5. Dehydration.

6. Depression.

7. Choking.

8. Paralysis.