Ch 14: What are cerebrovascular diseases

Question 1

What is a cerebrovascular disease (CVD)

Answer 1

most common after 65
infarct: obstruction of an artery –> blood supply is impaired/blocked
cerebral haemorrhage: rupturing of a weak spot in a blood vessel

acute phase: failure in arm/leg on one side of the body, hanging mouth, double tongue

Question 2

Infarct: aetiology

Answer 2

embolism –> temporary obstruction
embolism = coagulated blood platelets (trombi), calcifications,
local stenosis
inadequate blood flow

middle cerebral artery

Question 3

TIA: transient ischemic attack

Answer 3

temporary loss of function

persistent cognitive disorders

Question 4

Infarct: treatment + risk factors

Answer 4

trombolyse

age, atherosclerosis, high blood pressure

Question 5

Cerebral haemorrhage: aetiology

Answer 5

caused by long term hypertension
intracerebral most common type
subarachnoid (SAH): severe headache + neck stiffnes, caused by rupture or aneurysm (surgically closed)

Question 6

Differences neuropscyhological effects haemorrhages and infarcts: early stages after a stroke

Answer 6

Haemorrhage:
- consciousness decreased
- disorders severe and diffuse
- confused and disoriented
==> consequence of increased intracranial pressure + haematoma
- faster and better recovery than infarct

Infarct:
- damage restricted to arterial areas

Question 7

Stroke: memory disorders

Answer 7

50% memory disorders
first anterograde amnesia
mostly effects declarative memory
non-declarative is often intact

Question 8

Stroke: attention and speed of processing

Answer 8

40% attention problems

alertness & more complex attention functions

Question 9

Stroke: language

Answer 9

21-38% aphasia in acute phase

usually decrease substantially

Question 10

Stroke: perception

Answer 10

cerebral posterior artery –> visual field defect

Question 11

Stroke: executive functions

Answer 11

50% problem in executive functioning

planning, keeping track of situations, regulating behaviour

Question 12

Abulia

Answer 12

The inability to take initiative

Question 13

Stroke: social cognition

Answer 13

right side: initiating emotions

left side: inhibiting and controlling emotions

Question 14

Vascular dementia

Answer 14

25% of all stroke patients 3-12 months after the incident
rarely caused by a single infarct, often multiple infarction that occur simultaneously or shortly after one another in multiple places in the brain

Goes together with leukoaraiosis: progressive damage to the deep white matter in the brain

small vessel disease can also cause vascular dementia

psychomotor slowness
executive function disorders

Question 15

Other consequences after stroke

Answer 15

Disorientation (place person time) 
- better oriented --> better prognosis 
fatigue
depression
- almost all experience mood changes 
a catastrophic reaction

Question 16

Reduplicative paramnesia

Answer 16

Delirium can be accompanied by this (after stroke in right hemisphere)
patient does not recognise his/her environment and insists that his/her family is not his/hers