Cerebrovascular Accident (CVA) Overview
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Questions and Answers

What type of stroke is caused by a blockage that interrupts blood flow to the brain?

  • Haemorrhagic stroke
  • Silent stroke
  • Ischaemic stroke (correct)
  • Transient stroke
  • Dizziness and loss of balance are common signs of a stroke.

    True (A)

    Name one common symptom of stroke that affects communication.

    Dysphasia or dysarthria

    A severe and abrupt onset headache can be a sign of a __________ stroke.

    <p>haemorrhagic</p> Signup and view all the answers

    Match the following symptoms with their descriptions:

    <p>Hemiplegia = Weakness affecting one side of the body Dysphagia = Difficulty swallowing Loss of balance = Unexplained fall or unsteadiness Cognitive disorders = Issues with thinking or perception</p> Signup and view all the answers

    What is another name for cerebrovascular accident (CVA)?

    <p>Stroke (C)</p> Signup and view all the answers

    Hemorrhagic stroke is caused by a blockage in blood vessels.

    <p>False (B)</p> Signup and view all the answers

    Which of the following improves outcomes in stroke recovery?

    <p>Early and comprehensive rehabilitation (C)</p> Signup and view all the answers

    What is the main cause of stroke in people under 40 years of age?

    <p>High blood pressure</p> Signup and view all the answers

    A cerebrovascular accident results in the acute loss of blood flow to the brain due to an __________ or __________ stroke.

    <p>infarct, haemorrhage</p> Signup and view all the answers

    Diagnosis and immediate referral to a stroke team is unnecessary due to advances in reperfusion therapies.

    <p>False (B)</p> Signup and view all the answers

    What should be managed in stroke patients through standardised protocols?

    <p>Fever, glucose, and swallowing difficulties</p> Signup and view all the answers

    Match the following clinical presentations to their descriptions:

    <p>Hemiplegia = Weakness or numbness on one side of the body Dysphasia = Difficulty speaking or understanding Dizziness = Loss of balance or unexplained falls Dysphagia = Difficulty swallowing</p> Signup and view all the answers

    The ________ team is involved in the acute management of stroke patients.

    <p>interdisciplinary</p> Signup and view all the answers

    Which of the following is NOT a modifiable risk factor for stroke?

    <p>Age (D)</p> Signup and view all the answers

    Match the following roles with their primary responsibilities in stroke management:

    <p>Physiotherapist = Improving mobility and strength Occupational Therapist = Assisting with daily activities Speech Pathologist = Addressing communication issues Rehabilitation Physician = Overseeing rehabilitation programs</p> Signup and view all the answers

    Stroke occurs more frequently in metropolitan areas than in regional areas.

    <p>False (B)</p> Signup and view all the answers

    What percentage of children with sickle cell disease experience stroke?

    <p>8%</p> Signup and view all the answers

    Mobilisation should begin within how many hours after stroke onset?

    <p>48 hours (D)</p> Signup and view all the answers

    Group circuit class therapy is discouraged in stroke rehabilitation.

    <p>False (B)</p> Signup and view all the answers

    What type of training is recommended to improve strength in stroke survivors?

    <p>Progressive resistance training</p> Signup and view all the answers

    What is the primary focus of the Australian and New Zealand Living Clinical Guidelines for Stroke Management?

    <p>Physical rehabilitation after stroke (B)</p> Signup and view all the answers

    Very early mobilisation within 24 hours of stroke onset is shown to be ineffective based on recent studies.

    <p>False (B)</p> Signup and view all the answers

    What is the significance of goal setting in stroke rehabilitation according to the systematic review?

    <p>Goal setting enhances motivation and improves rehabilitation outcomes.</p> Signup and view all the answers

    Progressive resistance training increases _______ after stroke.

    <p>strength</p> Signup and view all the answers

    Match the following studies with their findings:

    <p>AVERT = Efficacy of early mobilization CIRCIT = Comparative study on rehabilitation intensity Veerbeek et al. = Evidence for physical therapy poststroke Dorsch et al. = Impact of resistance training on strength</p> Signup and view all the answers

    Which of the following studies focused on the intensity of therapy after stroke?

    <p>CIRCIT (C)</p> Signup and view all the answers

    According to the findings, increasing the amount of usual rehabilitation has a negative impact on activity after stroke.

    <p>False (B)</p> Signup and view all the answers

    Name one factor that can improve rehabilitation outcomes for stroke patients.

    <p>Increased rehabilitation intensity or structured goal-setting.</p> Signup and view all the answers

    Which of the following is a common sign of stroke involving speech?

    <p>Dysphasia (B)</p> Signup and view all the answers

    All strokes are caused by a blockage in blood vessels.

    <p>False (B)</p> Signup and view all the answers

    List one common symptom of stroke related to vision.

    <p>Blurred or decreased vision</p> Signup and view all the answers

    What is one of the non-modifiable risk factors for stroke?

    <p>Family history (C)</p> Signup and view all the answers

    Name one common symptom of stroke that affects mobility.

    <p>Hemiplegia</p> Signup and view all the answers

    A cerebrovascular accident may result from either an __________ or __________ stroke.

    <p>ischaemic, haemorrhagic</p> Signup and view all the answers

    Match the following types of strokes with their definitions:

    <p>Ischaemic stroke = Caused by blockage of blood flow Haemorrhagic stroke = Caused by rupture of blood vessels Transient Ischaemic Attack = Temporary blockage of blood flow Cerebral Infarction = Brain tissue death due to lack of blood flow</p> Signup and view all the answers

    Which of the following is a common symptom of dysphasia?

    <p>Difficulty speaking or understanding language (A)</p> Signup and view all the answers

    Younger individuals are more likely to experience strokes than older individuals.

    <p>False (B)</p> Signup and view all the answers

    Which of the following has been shown to improve recovery outcomes in stroke patients?

    <p>Early and comprehensive rehabilitation (D)</p> Signup and view all the answers

    Diagnosis and immediate referral to a stroke team is crucial due to advancements in reperfusion therapies.

    <p>True (A)</p> Signup and view all the answers

    What is a common cause of stroke in children with sickle cell disease?

    <p>Vascular complications</p> Signup and view all the answers

    What type of therapy should be utilized to increase scheduled therapy time during stroke rehabilitation?

    <p>Group circuit class therapy</p> Signup and view all the answers

    Stroke patients should begin _______ within 48 hours of onset, unless contraindicated.

    <p>mobilisation</p> Signup and view all the answers

    Match the stroke management team members with their roles:

    <p>Physiotherapy = Improves mobility and strength Dietician = Manages nutritional needs Speech Pathology = Addresses communication difficulties Rehabilitation Physician = Oversees overall recovery</p> Signup and view all the answers

    Which protocol should be implemented to manage physiological issues in stroke patients?

    <p>Manage fever, glucose, and swallowing difficulties (A)</p> Signup and view all the answers

    Collaborative goal setting in physiotherapy is done without the participation of the stroke survivor and their family.

    <p>False (B)</p> Signup and view all the answers

    Which specific exercise approach is recommended to improve cardiorespiratory fitness in stroke rehabilitation?

    <p>Individually-tailored exercise interventions</p> Signup and view all the answers

    What is the primary benefit of very early mobilisation within 24 hours of stroke onset?

    <p>Enhancing recovery outcomes (B)</p> Signup and view all the answers

    Prolonged bed rest is recommended after a stroke.

    <p>False (B)</p> Signup and view all the answers

    Name one significant factor that can improve rehabilitation outcomes for stroke patients.

    <p>increased rehabilitation intensity</p> Signup and view all the answers

    Which of the following is a key focus of the Australian and New Zealand Living Clinical Guidelines for Stroke Management?

    <p>Standardized protocols for management (D)</p> Signup and view all the answers

    Circuit class therapy is discouraged in stroke rehabilitation.

    <p>False (B)</p> Signup and view all the answers

    What is the recommended timeframe to begin physical rehabilitation after a stroke?

    <p>within 24 hours</p> Signup and view all the answers

    Flashcards

    Cerebrovascular Accident (CVA)

    Sudden loss of blood flow to the brain, causing brain cell death. Also known as a stroke.

    Ischemic Stroke

    A stroke caused by a blocked blood vessel in the brain.

    Hemorrhagic Stroke

    A stroke caused by a blood vessel bursting in the brain, leading to bleeding.

    Stroke Risk Factors (Modifiable)

    Factors that can be changed to reduce your stroke risk (e.g. high blood pressure, high cholesterol).

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    Stroke Symptoms

    Symptoms vary, depending on the brain area affected (e.g., weakness, speech problems, vision loss).

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    Hemiplegia

    Weakness or numbness on one side of the body.

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    Dysphasia/Dysarthria

    Difficulty speaking or understanding language.

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    Stroke Consequences

    Can lead to permanent disability or death.

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    Stroke recovery time

    Stroke recovery can take many months or years.

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    Early rehabilitation

    Early and comprehensive rehabilitation improves stroke outcomes.

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    Stroke diagnosis importance

    Quick diagnosis and referral to a stroke team is critical for reperfusion therapies.

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    Stroke unit treatment

    Stroke patients are admitted to a hospital stroke unit for interdisciplinary care.

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    Mobilisation timeframe

    Stroke patients should start moving (out of bed) within 48 hours, unless medically contraindicated.

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    Structured therapy

    Stroke rehabilitation should include scheduled occupational and physical therapy sessions.

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    Multidisciplinary Team

    A team of healthcare professionals, like physiotherapists, occupational therapists, speech pathologists, social workers, etc., works together to help stroke survivors.

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    Goal Setting in Physiotherapy

    Physiotherapy goals should be collaborative, specific, well-defined, and challenging for stroke survivors.

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    Stroke Rehabilitation Guidelines

    Clinical guidelines for managing stroke, developed for Australia and New Zealand.

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    Early Mobilization (Stroke)

    Starting physical activity within 24 hours of a stroke.

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    Progressive Resistance Training (Stroke)

    Exercise program increasing resistance to build strength after stroke.

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    Rehabilitation Intensity (Stroke)

    Measures how much effort is put into stroke recovery sessions.

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    Dose-Response Relationship (Stroke Rehab)

    Impact of the amount of therapy on stroke recovery.

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    Physical Rehabilitation Timing (Post-Stroke)

    When to start physical rehabilitation after stroke.

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    Stroke Rehabilitation Intervention Efficacy

    Effectiveness of various rehabilitation strategies in stroke recovery.

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    Goal Setting in Stroke Rehabilitation

    Establishing achievable goals to guide stroke recovery.

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    What is a stroke?

    A stroke happens when blood flow to the brain is suddenly interrupted. This can be due to a blocked blood vessel (ischemic stroke) or a burst blood vessel (hemorrhagic stroke).

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    What are common stroke signs?

    Common stroke signs include: weakness on one side of the body, speech difficulties, dizziness, vision changes, severe headache, trouble swallowing, and cognitive problems.

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    What's hemiplegia?

    Hemiplegia is weakness or paralysis affecting one side of the body.

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    What's the main cause of stroke?

    Stroke occurs when an artery in the brain gets blocked or bursts, interrupting blood flow to the brain.

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    What is a CVA?

    A cerebrovascular accident (CVA) is the medical term for a stroke, which is often caused by a blocked blood vessel (ischemic stroke) or a bleeding vessel (hemorrhagic stroke) in the brain.

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    What are the modifiable risk factors for CVA?

    Factors we can modify to reduce Stroke risk include: high blood pressure, high cholesterol, smoking, obesity/overweight, diet, lack of exercise and alcohol.

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    What are some non-modifiable risk factors for CVA?

    Factors we cannot control that increase CVA risk include: age, gender, family history, and certain medical conditions like atrial fibrillation.

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    What happens in an ischemic stroke?

    An ischemic stroke happens when a blood clot or other blockage obstructs an artery in the brain, cutting off blood flow and causing brain cell death.

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    Explain a hemorrhagic stroke.

    A hemorrhagic stroke occurs when a blood vessel bursts in the brain, causing bleeding into the brain tissue, damaging nearby cells.

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    What are some common symptoms of a stroke?

    Common stroke symptoms include weakness or numbness on one side of the body, slurred speech, sudden vision changes, dizziness, severe headaches, difficulty swallowing, and confusion.

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    What are the implications of a stroke?

    A stroke can lead to various impairments, including weakness or paralysis, speech difficulties, and cognitive problems. The severity of the stroke affects the potential for recovery.

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    What is the relationship between age and stroke?

    The risk of stroke increases significantly with age, however, strokes are uncommon in people under 40 years of age.

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    Stroke Team

    A group of healthcare professionals who specialize in diagnosing and treating strokes, including doctors, nurses, therapists, and other specialists.

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    Reperfusion Therapies

    Treatments aimed at restoring blood flow to the brain after a stroke, like using medications to dissolve blood clots or surgery to open blocked arteries.

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    Standardized Protocols

    Predetermined guidelines and procedures used to manage common stroke complications like fever, blood sugar issues, and swallowing problems.

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    Mobilisation

    Getting a stroke survivor out of bed and moving around to promote physical activity and recovery.

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    Group Circuit Class Therapy

    A type of therapy where a group of stroke survivors does a series of exercises together, increasing the intensity and duration of therapy.

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    Collaborative Goal Setting

    Working together with the stroke survivor and their family to set achievable and personalized recovery goals.

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    Progressive Resistance Training

    A type of exercise that gradually increases the amount of weight or resistance used to strengthen muscles after a stroke.

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    What causes an ischemic stroke?

    An ischemic stroke occurs when a blood clot or other blockage obstructs an artery in the brain, cutting off blood flow and causing brain cell death.

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    What causes a hemorrhagic stroke?

    A hemorrhagic stroke occurs when a blood vessel bursts in the brain, causing bleeding into the brain tissue, damaging nearby cells.

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    Early Mobilization in Stroke

    Starting physical activity within 24 hours of a stroke onset, as long as it's medically safe. It helps improve recovery and reduces complications.

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    Progressive Resistance Training (PRT)

    A type of exercise that gradually increases the resistance to build strength and endurance after a stroke. It helps improve muscle function.

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    Rehabilitation Intensity

    The amount of effort put into stroke recovery sessions. It's important to find the right balance of challenge and rest for each individual.

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    What is the dose-response relationship in stroke rehab?

    The impact of the amount of therapy on stroke recovery. Generally, more therapy leads to better outcomes, but it's important to find the right amount for each individual.

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    When should physical rehab begin after stroke?

    Ideally, physical rehabilitation should begin as soon as possible after a stroke, within 24 hours, if medically safe. This early intervention can significantly improve recovery.

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    What are the benefits of early and comprehensive rehabilitation after a stroke?

    Early and comprehensive rehabilitation helps improve functional abilities, reduce disability, and increase independence in stroke survivors.

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    What type of team is involved in stroke rehabilitation?

    Stroke rehabilitation involves a multidisciplinary team, including doctors, nurses, physiotherapists, occupational therapists, speech therapists, social workers, and others, all working together to help stroke survivors.

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    What are some key elements of goal setting in physiotherapy for stroke survivors?

    Physiotherapy goals should be collaborative, specific, well-defined, and challenging for each stroke survivor. It should be a shared process between the therapist and patient.

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    Study Notes

    Cerebrovascular Accident (CVA)

    • A CVA is a sudden interruption of blood flow to the brain
    • It can be caused by an infarct (ischemic stroke) or hemorrhage (hemorrhagic stroke)
    • Irreversible brain tissue damage results
    • Also known as a "stroke"

    Objectives

    • Students will be able to explain CVA in patient-appropriate language.
    • They will be able to identify risk factors for CVA.
    • They will describe basic clinical presentations of CVA.
    • Students will also respond to clinical questions about CVA patterns.

    Definition of CVA/Stroke

    • Acute loss of blood flow to the brain.
    • Can be an infarct (ischemic stroke).
    • Or hemorrhage (hemorrhagic stroke).
    • Results in irreversible brain tissue damage.

    Burden of Disease

    • Globally, 15 million people suffer a stroke annually with 5 million deaths and another 5 million permanently disabled (WHO 2023).
    • In Australia, a stroke occurs every 19 minutes (Stroke Foundation 2023).
    • Regional Australians are significantly more likely to have a stroke (17% more) than those in metropolitan areas (Stroke Foundation 2023).
    • Strokes are less common in people under 40. High blood pressure is the primary cause if it does occur in this age bracket (WHO 2023).
    • Approximately 8% of children with sickle cell disease experience a stroke (WHO 2023).

    Aetiology/Risk Factors

    • Modifiable: High blood pressure, high cholesterol, smoking, obesity/overweight, diet, lack of exercise, alcohol.
    • Medical: Atrial fibrillation, diabetes, fibromuscular dysplasia (FMD).
    • Non-modifiable: Age, gender, family history.

    Pathophysiology

    • Interrupted blood supply: Brain cells die due to lack of oxygen and nutrients.
    • Haemorrhage: Blood loss due to ruptured blood vessels, potentially associated with vessel disease.
    • Infarct: Blockage by a thrombus or embolus (material such as air).

    Clinical Presentation

    • FAST: Face drooping, Arm weakness, Speech difficulty, Time to call emergency services.
    • Location-Dependent:
      • Hemiplegia (weakness/numbness) affects one side of the body
      • Problems with speaking/understanding (dysphasia/dysarthria)
      • Dizziness, balance loss, unexplained falls
      • Vision changes (blurred/decreased vision)
      • Headache (severe, abrupt onset)
      • Difficulty swallowing (dysphagia)
      • Cognitive/perceptual disorders.

    Course and Prognosis

    • Stroke course is variable and depends on stroke severity, type, and age.
    • Initial recovery is most rapid within days (as swelling subsides).
    • Further recovery is possible for months or years.
    • Comprehensive rehabilitation significantly improves outcome.

    Diagnosis

    • Immediate referral to a stroke team is crucial, given advancements in reperfusion therapies.
    • Strong collaboration between emergency and stroke teams is essential for timely assessment and management.
    • Investigations include CT and MRI scans.

    Management: Acute

    • Hospital admission to a stroke unit with an interdisciplinary team.
    • Implement standardized protocols for fever, glucose, and swallowing difficulties management.
    • Consider antithrombotic therapy or surgery.

    Management: Rehabilitation

    • Begin mobilization (out-of-bed activity) within 48 hours (unless contraindicated).
    • Provide structured therapy (occupational and physiotherapy).
    • Group circuit class therapy to increase therapy time.

    The Multidisciplinary Team

    • Physiotherapy
    • Occupational Therapy
    • Speech Pathology
    • Social Worker
    • Rehabilitation Physician
    • Orthotist
    • Pharmacist
    • Neuropsychologist
    • Clinical Exercise Physiologist
    • Dietician
    • Nurse
    • Counsellor

    Physiotherapy Management

    • Collaborative goal setting with stroke survivor and caregiver (specific, challenging).
    • Progressive resistance training to regain strength.
    • Individualized exercise interventions for improved cardiorespiratory fitness.
    • Task-specific repetitive practice (e.g., sit to stand, walking).

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    Description

    This quiz dives into the essential aspects of Cerebrovascular Accidents, commonly known as strokes. Students will learn to explain CVA, identify its risk factors, and describe clinical presentations. It also covers the global burden of stroke, highlighting its significance in healthcare.

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