Medical Topic Research Blog

Topic: Cerebrovascular Accident by Sabrina Johnston

Definition and Analysis of Five Terms

Angiography

angi/o (CF) = vessel

-graphy (S) = recording

Definition: An angiography is an x-ray recording of a bood vessel after the injection of a radiopaque substance.


Cerebrovascular

cerebr/o (CF) = cerebrum

vascul (R) = small vessel

-ar (S) = pertaining to

Definition: Cerebrovascular means pertaining to the blood vessels of the cerebrum.


Hemorrhage

hem/o (CF) = blood

-rrhage (S) = to burst forth, bursting forth

Definition: Homorrhage means the bursting forth of blood.


Tomography

tom/o (CF) = to cut

-graphy (S) = recording

Definition: A tomography is an x-ray or an ultrasound displaying a representation of a cross section through a human body.


Vasospasm

vas/o (CF) = vessel

-spasm (S) = tension, spasm, contraction

Definition: A vasospasm is a spasm of a blood vessel.

Summary

Cerebrovascular accidents, commonly know as strokes, are caused by ceasing of blood flow to part of the brain which in turn prevents the brain from receiving oxygen (Campellone, 2014). Of all strokes, 87% are ischemic, 10% are intracerebral hemorrhage, and 3% are subarachnoid hemorrhage stroke (Timely Data Resources, Inc, 2011). Hemorrhage strokes are caused by a blood vessel in the brain weakening and then bursting open. One of the leading causes of a subarachnoid hemorrhage (SAH) is an aneurysm (Campellone, 2014). Aneurysms arise when the wall of a blood vessel in the brain weakens (Campellone, 2014). SAH caused by an aneurysm has a mortality rate of 67% (Ji & Chen). Symptoms of a stroke include a change in alertness, eyesight problems, muscle weakness in usually one side of the body, trouble speaking, and trouble walking (Campellone, 2014). Symptoms of an aneurysm include a sudden intense headache, loss of vision, vomiting, dizziness, seizures, or paralysis on one side of the body (Cedars-Sinai, 2015).
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-----------------------------------------Subarachnoid Hemorrhage-----------------------------------------
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-----------------------------------------------------Aneurysm----------------------------------------------------
Those treating SAH focus on stopping the bleeding, restoring normal blood flow, relieving the pressure on the brain, and preventing vasospasm (Zuccarello & Ringer, 2013). In order to diagnose SAH, doctors use either a computed tomography (CT) scan or a lumbar puncture (spinal tap) (Cedars-Sinai, 2015). If they diagnosis SAH caused by an aneurysm, the stroke team will first do either a magnetic resonance angiography (MRA) or a CT angiography (CTA) to locate the aneurysm and where to operate (Cedars-Sinai, 2015). To repair the aneurysm, doctors can either clip it off during open brain surgery or correct it through endovascular repair (Campellone,2014). The Cochrane Stroke Group performed a blind study in 1989 to determine the best time to perform surgery on an aneurysm. Of the 216 patients that they studied, five were omitted from the study due to the emergency of their state, 71 patients had an early surgery (day 0-3), 70 had intermediate surgery (day 4-7), and 70 had late surgery (day 8+). Three months after the operations, 65 (92%) of those who had early surgery, 55 (79%) of those who had intermediate surgery, and 56 (80%) of those who had late surgery were independent. 2 (3%) of those who had early surgery, 11 (16%) of those who had intermediate surgery, and 5 (7%) of those who had late surgery were dependent. The fatality rates were 6% of those who had early surgery, 6% of those who had intermediate surgery, and 13% of those who had late surgery. Since this study was published, treatment of SAH has improved possibly changing the validity of its data. Today, most neurosurgeons elect to perform surgery within 3 or 4 days (Whitfield, 2010).


After surgery, the road to recovery from a SAH is not over. Depending on the injuries sustained, the patient may need to go through therapy to regain use of their body. Mayo Clinic lists the various therapys that could take place including strengthening motor skills, mobility training, constraint-induced therapy, and range-of motion therapy. These all deal with helping the physical body to recover. Types of cognitive therapy include therapy for communication disorders, psychological evaluation and treatment, and medications (Mayo, 2014).

Works Cited

436. Stroke (General Comments); Cerebrovascular Accident (CVA); Cerebrovascular Disease (Ischemia); Ischemic Stroke; Hemorrhagic Stroke. Capitola: Timely Data Resources, Inc, 2010. ProQuest. Web. 21 Oct. 2015. <http://search.proquest.com.ezproxy.unwsp.edu/pqrl/docview/192457569/6FA2B94E114B4806PQ/1?accountid=12915>.


"Result Filters." National Center for Biotechnology Information. U.S. National Library of Medicine, n.d. Web. 21 Oct. 2015. <http://www.ncbi.nlm.nih.gov/pubmed/26463934>.


Whitfield, Peter C. "Timing Of Surgery For Aneurysmal Subarachnoid Haemorrhage." Cochrane Database Of Systematic Reviews 10 (2010): Cochrane Database of Systematic Reviews. Web. 21 Oct. 2015. <http://eds.b.ebscohost.com.ezproxy.unwsp.edu/ehost/detail/detail?vid=2&sid=3de2cd43-ebee-47ab-9826-2831b08e7158%40sessionmgr111&hid=127&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=CD001697&db=chh>.


"Aneurysms and Subarachnoid Hemorrhage." Aneurysms and Subarachnoid Hemorrhage. N.p., n.d. Web. 26 Oct. 2015. <http://www.cedars-sinai.edu/Patients/Programs-and-Services/Stroke-Program/Stroke-Resources/Aneurysms-and-Subarachnoid-Hemorrhage.aspx>.


"Stroke: MedlinePlus Medical Encyclopedia." U.S National Library of Medicine. Ed. Joseph V. Campellone. U.S. National Library of Medicine, n.d. Web. 27 Oct. 2015. <https://www.nlm.nih.gov/medlineplus/ency/article/000726.htm>.


"Subarachnoid Hemorrhage (SAH)." Subarachnoid Hemorrhage (SAH). Ed. Mario Zuccarello and Andrew Ringer. N.p., n.d. Web. 27 Oct. 2015. <http://www.mayfieldclinic.com/PE-SAH.HTM#.Vi7C9Cgx_8s>


"Stroke Rehabilitation: What to Expect as You Recover." From Stroke. Mayo Clinic, 11 June 2014. Web. 27 Oct. 2015. <http://www.mayoclinic.org/stroke-rehabilitation/art-20045172>.