2. Causes of Stroke 80%Infarction 60%Cerebrovascularatherosclerosis20% Penetrating artery disease (lacunes) 15% Cardiogenic embolism 5%Other,unusualcausesHemorrhage - Intracerebral - Intracerebral - Subarachnoid - Subarachnoid20%

3. Lacunar Stroke

5. Types of CNS Hemorrhage Arteriovenous malformation

6. Summary Diagram of Causes of Stroke

7. Atrial Fibrillation (AF) Predisposes to Stroke

12. Physical –Right hemiplegia Cognitive –Aphasia, agraphia, alexia, ataxia, memory impairments –Confabulation, attentional deficits Emotional –Lability, low tolerance, depression (more common with right CVA) Assisting the Patient with a Left CVA –Speak slowly! Learn to recognize nonverbal cues from the patient –Let patient learn through imitation Left CVA

13. Right CVA u Physical u left hemiplegia u Cognitive u Difficulty with time and space, increased perceptual problems, decreased ability to recognize faces, decreases mathematical and reasoning skills u Decreased eye-hand coordination u Emotional u Lability, low tolerance, depression, denial u Assisting the Patient with a Left CVA u Emphasize verbal cues, use visual fields appropriately, keep everything related to safety on the right!!!!! u Decrease stimuli, break tasks into small steps

14. Lee, CD, AR Folsom, and SN Blair. Physical activity and stroke risk: A meta-analysis. Stroke 34:2475-2482, 2003. LOW vs. HIGH PHYSICAL ACTIVITY AND STROKE RISK

15. Wendle-Vos et al. International Journal of Epidemiology 33:787-798, 2004. RELATIVE RISK: PHYSICAL ACTIVITY AND STROKE

16. Potempa et al. Stroke 26:101-105, 1995. PHYSICAL WORK CAPACITY

17. Potempa et al. Stroke 26:101-105, 1995. BLOOD PRESSURE

18. Potempa et al. Stroke 26:101-105, 1995. EXERCISE BLOOD PRESSURES

19. Rimmer, JH., et al. Medicine and Exercise in Sports and Exercise 32:1991-1996, 2000. PHYSICAL WORK CAPACITY

20. Rimmer, JH., et al. Medicine and Exercise in Sports and Exercise 32:1991-1996, 2000. SRENGTH

21. Rimmer, JH., et al. Medicine and Exercise in Sports and Exercise 32:1991-1996, 2000. FLEXIBILITY

22. Macko, R.F., et al Stroke 28:326-330, 1997. EFFICIENCY OF MOVEMENT