1. Cerebral Vascular Accident (CVA) Stroke - Overview  Third leading cause of death in industrialized countries.  Total cost of strokes in the U.S. is roughly $43 billion a year.  $15,000 a year in medical care costs during the first 3 months after the attack.  Age is the principal risk factor.  Most strokes occur after the age of 65  More common in men  Second greatest risk factor is high blood pressure  Transient Ischemic Attack (TIA) - Symptoms are temporary but should be seen as a warning sign that a stroke is likely to occur.

2. Incidence  Approximately 500k Americans each year  3 million Americans have survived strokes  2 million Americans subsequently suffer from paralysis, speech & memory loss.

3. Symptoms  Depends on the type of stroke and location of the lesion  Contra-lateral impairment  Hemiparesis - weakness on one side of the body - entire side; face, arm, or leg  Drooping of the mouth  Drooling  Numbness on one side  Loss of vision in one visual field (transient monocular blindness)  Dysarthria (slurred speech)

4. Symptoms cont’d  Visual disturbances e.g. double vision, altered visual perception  Aphasia - difficulties with expressive and/or receptive language; can not name objects  Vertigo - dizziness, spinning sensation, imbalance  Memory difficulties  Behavioral or personality changes  Swallowing

5. Causes  Ischemic Stroke  85% of all strokes are from ischemia  Lack of blood flow, or major disturbance of blood flow due to the obstruction of a blood vessel  Atherosclerosis - an accumulation of plaque, cholesterol, and blood clots forms to the point of impeding subsequent blood flow.

6. Causes cont’d  Intracranial Hemorrhage  15% of strokes caused from hemorrhage (bleeding) in the brain  Hypertension, bleeding from tumors, trauma, illicit drug use, high blood pressure  Pt.s experience a sudden headache, vomiting, depressed level of consciousness  Some symptoms are caused by pressure associated with blood accumulation which is referred to as a hematoma

7. Warning Signs  Sudden numbness or weakness of the face, arm, or leg, especially if it is unilateral  Sudden confusion, difficulty speaking or understanding speech  Sudden difficulty seeing in one or both eyes  Sudden difficulty walking dizziness, loss of balance or coordination  Sudden severe headache with no known cause