Acquired Brain Injury - Stoke and TBI Flashcards
Cerebral Vascular Accident (Stroke) - Definition
Clinical syndrome consisting of rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24h or leading to death with no apparent cause other than a vascular origin.
How long can a acute state, caused by a cerebrovascular injury, last? and what happens after this period.
Between 6-8 weeks.
After this period, signs of UMN related to spasticity can be seen in the contra-lateral body hemisphere, impairing functionality (ADLs).
Transient Ischemic Attack - Definition
Minor stroke. Temporary interruption of blood flow, producing symptoms that usually do not last over 72h. Considered a warning sign, leading to stroke in most cases.
No loss of consciousness. No long lasting damage.
Cryptogenic Stroke - Definition and Possible Causes (3)
All strokes that cannot be traced to a specific cause, but interruption of blood flow in a specific cerebral artery causes permanent neural damage, leading to sensorimotor or cognitive symptoms.
- Cardiovascular events
- Anatomical changes (cancer)
- Metabolic changes affecting permeability of vessels or composition of blood.
Modifiable Risk Factors (3) - Stroke
Physical inactivity (intensity influences risk for women)
Obesity (abdominal fat and BMI for women, only BMI for males)
Hypertension
Nonmodifiable Risk Factors (5) - Stroke
<45-85> years old.
Ethnicity (can be related to poor access to health care)
Arterial fibrillation
Type 1 diabetes
Genetic factor: gene in chromosome 9p21.
Which Arteries are most commonly damaged in a stroke (3)?
Anterior cerebral artery
Middle cerebral artery
Internal carotid artery
Traumatic Brain Injury - Contusion
Damage due to direct external forces (trauma) on the skull developing a hematoma.
Traumatic Brain Injury - Concussion - Cause, Sports, Recovery.
Most common traumatic encephalic diffuse lesion reported in different sports.
Caused by forces of inertia! Can lead to loss of consciousness and pos-traumatic amnesia, resolving spontaneously with time.
2-3 week recovery time.
Most Common Types of Hemorrhage (5)
Epidural Hemorrhage (EDH)
Subarachnoid Hemorrhage (SAH)
Subdural Hemorrhage (SDH)
Intraventricular Hemorrhage (IVH)
Intracranial Hemorrhage (ICH)
Epidural Hemorrhage (4) vs Subdural Hemorrhage (4)
Epidural: Convex - Convex, arterial blood, a lot of intracranial pressure, smaller area affected.
Subdural: Convex - concave, venous blood, less intracranial pressure, occupies more space.
Epidural Hemorrhage - Characteristics (5) Range in severity
Intracranial pressure (non-depressive fracture)
Deviation of the midline (we try to move all processes to the contralateral hemisphere)
Compression of subcortical structures
Compression of brainstem
Loss of consciousness
Subdural Hemorrhage - Possible Causes and Time Window
Lesion occurs inside a greater time window (venous bleeding), developing mostly to an acute phase in 3-7 days.
Often seen in patients on anticoagulants. Some genetic, integrity of blood vessels compromised.
Subarachnoid Hemorrhage - Most common people affected and most common etiologies
Most common in newborns, elderly or people with disorders affecting thickness, elasticity of arterial or venous walls.
Trauma and rupture of an aneurysm.
Intraventricular and Intracerebral Hemorrhage - Death of Neurons and Predictor sites (5)
From Trauma, death of neurons will happen due to pH differences, within 8 hours.
- Basal nuclei: 40-50%
- Cortical areas: 20-50%
- Thalamus/3rd ventricle: 10-15%
- Cerebellum: 5-10%
- Brainstem: 1-5%