Managing Client with Cerebrovascular Disease

• The accumulation of blood within the cranium, due either to head trauma or flaws in the cerebral vasculature

Aneesh Singhal, MD, author of Recognition and management of stroke in young adults and adolescents, from the Clinical Journal of the American Academy of Neurology states

1-Mr. Franklin had dizziness and was found on the floor. From his history, we know that two years ago he had a thrombotic cerebrovascular accident. The thrombotic cerebrovascular accident is unexpected death of some brain cells because of lack of oxygen when the blood supply to the brain is blocked by blood clots. This is also called stroke or CVA. This traumatic brain injury is related to blood vessel damage. Seizures and dizziness are some of the physical symptoms. We can rule out traumatic brain injuries like fluid buildup in the brain that could cause the brain to swell; skull fractures or wounds that can tear the meninges pooling blood outside the vessels and enabling the bacteria to infect the nervous system.

Different types of intracranial hemorrhages can occur due to injuries to the skull, either directly or indirectly. Epidural hematomas occur when a direct blow to the skull causes injury to the dural arteries or veins that lead to bleeding that accumulates between the dura matter and the skull. If the dural artery is injured, rapid deterioration of the patient neurologic status can occur. As the size of the epidural hematoma increases, the surrounding brain tissues is damaged due to the compression from the pressure of the blood accumulation. The patient may experience a dilated pupil on the side of the injury due to compression of the third cranial nerve. The patient may also complain of a severe headache, visual disturbances and weakness on the opposite side of the injury. If bleeding continues and increases the intracranial pressure, leading to brain shift or herniation of the brain stem which is irreversible and leads to hypertension, bradycardia and respiratory arrest. This trio of symptoms is called the Cushing’s Triad. Epidural hematomas can continue

Ischemic stroke is the blockage of blood vessels in the brain as a result of blood clots (thrombi), causing the portions of the brain nourished by the vessel and its tributaries to be starved of nutrients, poisoned, and to eventually die (“Symptoms

It was September 30th, 2004. Former Pittsburgh Steeler Justin Strzelczyk drove his Ford pickup drunk the wrong way across highway I-90 colliding head-on with a tanker truck and died on impact (Finder). Justin wasn’t on drugs or drinking(Finder). Justin had a bipolar disorder from concussions from when he played football (Finder). According to WebMD “The brain is made of soft tissue. It's cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain. Sometimes, it literally causes it to move around in your head. Traumatic brain injuries can cause bruising, damage to the blood vessels, and injury to the nerves” (Lava). In a short and sweet version; it is a bruise to the brain. Concussions also have different levels

When admitted, person suffering from a concussion may appear dazed or stunned, confused, answer questions slowly, repeat questions, and be unable to remember current events (Borich, 2013). Other physical symptoms may include headache, nausea, vomiting, balance problems, dizziness, visual problems including double vision and sensitivity to light, fatigue, numbness or tingling,

Subdural or Epidural bleeding – as bleeding grows it pushes on brain which will mean you have difficulty communicating and moving.

A stroke is a type of cardiovascular disease that affects the cerebral arteries, those blood vessels that carry blood to the brain. A stroke occurs when one of those blood vessels in the brain is obstructed or ruptures flooding the brain with blood. Depriving blood and oxygen to the brain results in those immediate cells death, causing the brain not to function properly. Once parts of the brain stop functioning, it can directly affect the areas of the body controlled (1).

A stroke is the sudden death of brain cells in a localized area due to inadequate blood

A skull fracture is an impact and open head injury; this occurs when the patient is struck in the head with an object. An epidural hematoma is not the same as an subdural hematoma. An epidural hematoma is an impact injury. This is when bleeding happens on the dura mater. A subdural hematoma is an acceleration/deceleration injury. This is occurs when bleeding happens on the

A concussion is “a clinical syndrome characterized by immediate and transient alteration of brain function, including alteration of mental status and level of consciousness, resulting from mechanical force or trauma” (American Association of Neurological Surgeons). Concussions are commonly seen in sports injuries in children and adolescents, but can also occur from falls, motor vehicle accidents, physical assault, and recreational injuries. In a concussion, a blow to the head or violent shaking causes the brain to twist or bump up against the skull. The force of the brain hitting the skull may tear blood vessels, pull, squeeze, stretch, or tear nerve fibers and neural cells, and bruise the brain (Brain Injury Association). This causes disruptions in brain processing and in turn all the symptoms associated with

Traumatic brain injuries can vary in their severity. In the case of mild brain injury, full recovery is possible. On the other hand, severe brain injury can be fatal or cause permanent disabilities, the type of which depend on the affected area of the brain. A head injury is usually obvious because of visible wounds to the head. However, the coup-contrecoup brain injury may occur without any exterior damage to the head or skull. The victim may first feel a headache, but because there's no evidence of a head injury, the coup-contrecoup may go undiagnosed and death may occur in a matter of hours or days.

Extradural hematoma (Epidural hematoma): “Bleeding between the dura mater and the skull caused most commonly by motor vehicle accidents and occasionally by falls and sporting accidents”(McCance & Huether, 2014, p. 584). It usually results from a “brief linear contact force to the calvaria that cause separation of the periosteal dura from bone and disruption of interposed vessels due

A cerebrovascular accident more commonly known as a stroke or brain attack is the term used to describe the sudden death of brain cells in a localized area due to inadequate blood flow. In order to woke the brain needs a constant supply of oxygen and nutrients. This supply is carried to the brain