DISEASES OF THE NERVOUS SYSTEM A stroke (to know)____________________ as cerebrovascular accident (CVA). It (to be)_____ an acute
neurologic injury in which the blood supply to a part of the brain (to interrupt)______________ It (to be)
______the third leading cause of death and adult disability in the US and industrialized European nations. Of j
every 5 deaths from stroke, 2 (to occur) _______ in men and 3 in women.
Risk factors (to include)________________advanced age, hypertension (high blood pressure), diabetes
mellitus, high cholesterol, and cigarette smoking. Cigarette smoking (to be)_____the most important risk
factor of stroke.
Strokes can (to classify)___________________ into two major categories: ischemic and hemorrhagic
Ischemic stroke (to occur)____________ in approximately 85-90% of strokes. In ischemic stroke, a blood
vessel (to become) _________occluded and the blood supply to part of the brain______ totally or
partially (to block).
Embolic stroke refers to the blockage of arterial access to a part of the brain by an embolus -- a traveling particle or debris in the arterial bloodstream originating from elsewhere. An embolus is most frequently a blood clot, but it can also be a plaque broken off from an atherosclerotic blood vessel or a number of other substances including fat (e.g., from bone marrow in a broken bone), air, and even cancerous cells. Another cause is bacterial emboli released in infectious endocarditis.
A hemorrhagic stroke, or cerebral hemorrhage, (to be) ______ a form of stroke that (to occur)_________ when
a blood vessel in the brain (to rupture)__________ ____ or (to bleed) ________ Hemorrhagic strokes (to
be)________more dangerous than ischemic strokes.
The symptoms of stroke (to depend)_______________on the type of stroke and the area of the brain
affected. Ischemic strokes usually only (to affect)______ _ regional areas of the brain. Hemorrhagic strokes
can (to affect) ____________ local areas, but often can also (to cause)___________more global
symptoms due to bleeding and increased intracranial pressure.
Symptoms may (to include) : muscle weakness or numbness (hemiplegia),
reduction of pain or temperature sensation, reduction in sensory or vibratory sensation
In most cases, the symptoms (to affect)___________one side of the body, from the neck downwards,
excluding the face. There may (to be)___________:
• altered smell, taste, hearing, or vision (total or partial)
• drooping of eyelid (ptosis) and weakness of ocular muscles
• decreased reflexes
• decreased sensation and muscle weakness of the face
• balance problems
• altered breathing and heart rate
• inability to turn head to one side
• weakness in tongue (inability to protrude and/or move from side to side) Strokes also can also (to produce)__________________the following symptoms:
• aphasia (inability to speak or understand)
• altered voluntary movements
• disorganized thinking, confusion
• altered vision
• memory deficits
If the cerebellum is involved, the patient may have the following: trouble walking, altered movement
coordination, dizziness.
Loss of consciousness, headache, and vomiting usually (to occur)__________more often in hemorrhagic
stroke than in thrombosis. If the symptoms (to resolve)________________ within an or maximum 24 hours the diagnosis (to be)________
transient ischemic attack (TIA), and not a stroke. This syndrome may (to be)_____a warning sign,
and a large proportion of patients (to develop)______________ strokes in the future.
Stroke (to diagnose)________________ through several techniques: a neurological examination, blood tests,
CT scans or MRI scans, Doppler ultrasound, and arteriography.
It (to be) ______ important to identify a stroke as early as possible because patients who (to treat)
________earlier (to have)_____________better recoveries.
