The brain controls how our body functions, how we think, how we see, how we talk, and how

we move. The signals to and from the brain are transmitted through the spinal cord to the rest of the body.

The right side of the brain controls the left side of the body, and the left side of the brain controls the right side of the body. This includes movement and sensation. Speech centers usually are located in the Broca's area on the left side of the brain. Vision is controlled by the back of the brain in the occipital lobes. The carotid arteries provide the majority of the blood supply to these parts of the brain (known as the anterior circulation). Balance and coordination are controlled by the cerebellum, or the base of the brain, and its blood supply comes from the vertebral arteries located in the bony canals in the back of the vertebral column (referred to as the posterior circulation).

form small clots. These clots can embolize to any organ in the body, but the brain is a common target. Debris can occlude the blood vessels and stop blood flow. This debris often breaks off from carotid arteries that are narrowed by the atherosclerotic disease process described above. Blood vessels can leak and cause bleeding within the brain tissue. An intracerebral hemorrhage (intra=within + cerebral= of the brain + hemorrhage=bleeding) is often caused by high blood pressure which can cause small blood vessel walls to become thin and weak.

Trends: The ABCD2 score (Age, Blood pressure, Clinical features, Duration of symptoms and Diabetes) is commonly used as a tool for physicians to identify people at high-risk of stroke after transient ischemic attacks, although it has not been widely applied clinically by physicians at the bedside. Study: designed to assess the effectiveness of the ABCD2 score, included 2056 patients aged 18 or older who experienced a transient ischemic attack or minor stroke at eight Canadian emergency departments between 2007 and 2010. The mean age of the patients was 68 years, and half were female. For most patients, this was their first transient ischemic attack; about half experienced motor weakness, one-third reported speech irregularities and most had symptoms for at least 10 minutes. Thirty-eight (1.8%) of patients had a stroke within 7 days of the first visit and 65 (3.2%) within 90 days. An additional 201 patients (9.8%) had a second transient ischemic attack between 7 and 90 days. Findings: ABCD2 score of more than five had low sensitivity for predicting subsequent stroke at 7 or 90 days Conclusion: The ABCD2 score can be credited for increasing awareness of transient ischemic attack as a medical emergency that carries with it a substantial and modifiable risk for subsequent stroke; This study determined that the criteria used to calculate the score are not sensitive enough to classify patients as being at low risk. We also determined that the 2009 recommendation by the American Heart Association of using an ABCD2 score of more than two to determine high risk has a very low specificity, classifying almost all patients as requiring immediate imaging and perhaps admission to hospital. Reason for Choosing the Case The nature of the case study was deemed to be motivating and challenging case for the student nurses. The researchers of this case study have chosen to indulge in such illness for the reason that the researchers would like to increase the depth of their knowledge on this particular disease. As hypertension continuously affects millions of women across the globe, it will be helpful as future nurses to address this disease in diverse cultural settings. Having such case for the study gives the opportunity for the student nurses to familiarize themselves with the latest trends, discoveries, and management as well as the essential interventions of the disease.

When an area of the brain loses its blood supply it stops working and the part of the body it controls also stops working. This is what happens with a stroke or CVA (cerebrovascular accident). When the brain loses blood supply, it tries to restore blood flow. If blood supply is restored, function may return to the affected brain cells, permitting return of function to the affected body part. This is what happens with a TIA (transient ischemic attack). Some may consider this a mini-stroke, however, in reality, it is a stroke that has resolved or has improved functionality in the affected body part. By definition, a TIA resolves within 24 hours, but most TIA symptoms resolve within a few minutes. TIAs are often warning signs of a future stroke. The risk of a stroke increases dramatically in the days after a transient ischemic attack, and the TIA may offer an opportunity to find a cause or minimize the risk to prevent the permanent neurologic damage that results because of a stroke. Causes: Brain cells require oxygen and glucose to function. If the blood supply is lost, then nutrient supply is lost, and the brain cells stop working. The blood supply to brain cells can be lost in a few different ways. Blood clots can form in one of the tiny arteries of the brain (thrombosis). This is usually preceded by gradual narrowing of the blood vessel by fatty buildup called plaque. Atherosclerosis (atheroma=deposits of cholesterol and fatty tissue + sclerosis + narrowing) of the brain arteries is the same as the narrowing that occurs in heart arteries preceding a heart attack. A blood clot can form if the plaque ruptures, leading to further blockage of the artery. Blood clots can float downstream from the heart and get caught in a tiny blood vessel (embolus). Atrial fibrillation (A fib) is the most common reason for an embolus. In atrial fibrillation, the upper chambers of the heart jiggle and don't beat in a coordinated fashion. This allows blood to become stagnant and