CVA

Question 1

What does the ACA supply

Answer 1

the medial surfaces of the frontal and parietal lobe

Question 2

what does the MCA supply

Answer 2

lateral surfaces of the frontal, temporal and parietal lobes and insula

Question 3

what does the PCA supply

Answer 3

occipital lobe
midbrain
thalamus
medial surfaces of parietal and temporal lobes

Question 4

what do the vertebral arteries supply?

Answer 4

superior cerebellar artery, inferior cerebellar artery

posterior inferior cerebellar artery

Question 5

what do the basilar arteries supply

Answer 5

pons

Question 6

symptoms of damage to the ACA

Answer 6

LE hemiplegia > UE hemiparesis
Hemisensory loss
Urinary incontinence
perseveration
lack of spontaneity/motor inaction

Question 7

symptoms of damage to the MCA

Answer 7

Facial involvement
UE hemplegia > LE
Partial or complete hemisensory loss
Homonomous hemanopsia
Agnosias
Unilateral neglect
Aphasias
Other perceptual deficits

Question 8

symptoms of damage to the PCA

Answer 8

Homonomous hemianopsia
Cortical blindness
Weber’s syndrome (CN III on ipsilateral, contralateral hemiplegia due to cerebral peduncle)
Hemisensory loss
Memory deficit
Visual spatial deficits

Question 9

symptoms of damage to the vertebrals

Answer 9

ataxia
CNV-XII
Swallowing
Dizziness
Nausea
Dysarthria
Nystagmus
Facial sensory loss on same side

Question 10

symptoms of damage to the basilar artery

Answer 10

Infarct of pons
“locked in syndrome”
Disrupts corticobulbar and corticospinal tracts (quadriplegia)
Paralysis of lower cranial nerves
• Complete LIS: quadriplegia and anarthria. No eye movement
• Classic LIS: preserved vertical eye movement and blinking (CN III function spared)
• Incomplete LIS: recovery of some voluntary movements in addition to eye movements

Question 11

Right hemisphere damage

Answer 11

Left hemiplegia
Perceptual problems
Often impulsive
Lack of awareness of deficits
Neglect

Question 12

Left hemisphere damage

Answer 12

Motor and sensory losses
Abnormal tone
Depression and fatigue
Emotional lability
	Right hemiplegia
Cautious
Slow movement
Communication deficits

Question 13

What do both right and left hemisphere damage share?

Answer 13

Motor and sensory losses
Abnormal tone
Depression and fatigue
Emotional lability

Question 14

What type of stroke is more common

Answer 14

ischemic strokes

Question 15

types of ischemic strokes

Answer 15

embolic
thrombotic
hypoxic
lacunar

Question 16

what kind of stroke is more deadly but has a better recovery

Answer 16

hemorrhagic

Question 17

types of hemorrhagic strokes

Answer 17

primary intercerebral
aneurysms
ateriovenous malformatins

Question 18

describe embolic strokes

Answer 18

type of ischemic stroke
Most common of ischemic strokes
o Very quick onset
o Emboli usually arise in heart

Question 19

describe thrombotic strokes

Answer 19

type of ischemic stroke
o Forms mostly at bifurcations
o Sudden onset or slower evolution
o Many times occurs during sleep

Question 20

describe hypoxic strokes

Answer 20

type of ischemic stroke

due to shock, severe blood loss or cardiac arrest

Question 21

describe lacunar strokes

Answer 21

type of ischemic stroke
o	Small vessel disease
o	Due to untreated HTN
o	Multiple tiny areas of damage
o	Occurs mostly in basal ganglia
	Results in dense hemiplegia/hemisensory loss

Question 22

desvribe primary intercerebral sto

Answer 22

type of hemorrhagic stroke
due to HTM
if bleed is > 5 cm there is too much herniation and prognosis is not good

Question 23

describe aneurysms

Answer 23

type of hemorrhagic stroke
ballooining of vessel and thinning of the wall
can be congentital or degenerative
subarachnoid bleed can occur

Question 24

describe an arteriovenous malformation

Answer 24

type of hemorrhagic stroke
abnormal connection between artery and vein with thin walls so that the pressure is too high
you are usually born with this but the bleed occurs in the 20s and 30s

Question 25

what is a subarachanoid bleed

Answer 25

usually a slower bleed aneurysm of the vein

prognosis is better than an aneurysm

Question 26

What is a CVA

Answer 26

insufficient blood supply to the brain leading to death of neurons

Question 27

What is a TIA

Answer 27

neurologic deficits due to TEMPORARY ischemia lasting for minutes to hours and followed by complete restoration of function withing 24 hours
it is a warning sign

Question 28

what is a RIND

Answer 28

reversible ischemic neurological deficit

resolves in > 24 hours but

Question 29

typical problems and phenomenon of strokes

Answer 29

neuromuscular impairments
apraxias
somatosensory dysfunction
visual dysfunction
perceptual dysfunction
oral, speech and language disorders
cognitive deficits
emotional aspects
fatigue
perservation
dizziness or vertigo
incontinence
sexuality
family/social

Question 30

what is unilateral negelct

Answer 30

involuntary lack of attention to stimuli
often seen more often with right hemisphere damage
can be combined with homonymous hemianopsia

Question 31

what is denervation supersenstivity

Answer 31

neurons become more sensitive to inputs

Question 32

what is regenerative synaptogenesis

Answer 32

injured axons begin sproutingq

Question 33

what is reactive synaptogenesis

Answer 33

collateral sprouting

neighboring normal axons sprout to innervate synaptic sites taht were previously atcivated by injured axons

Question 34

What is the importance of these mechanisms?

Answer 34

neural plasticity