CVA Flashcards
What does the ACA supply
the medial surfaces of the frontal and parietal lobe
what does the MCA supply
lateral surfaces of the frontal, temporal and parietal lobes and insula
what does the PCA supply
occipital lobe
midbrain
thalamus
medial surfaces of parietal and temporal lobes
what do the vertebral arteries supply?
superior cerebellar artery, inferior cerebellar artery
posterior inferior cerebellar artery
what do the basilar arteries supply
pons
symptoms of damage to the ACA
LE hemiplegia > UE hemiparesis Hemisensory loss Urinary incontinence perseveration lack of spontaneity/motor inaction
symptoms of damage to the MCA
Facial involvement UE hemplegia > LE Partial or complete hemisensory loss Homonomous hemanopsia Agnosias Unilateral neglect Aphasias Other perceptual deficits
symptoms of damage to the PCA
Homonomous hemianopsia Cortical blindness Weber’s syndrome (CN III on ipsilateral, contralateral hemiplegia due to cerebral peduncle) Hemisensory loss Memory deficit Visual spatial deficits
symptoms of damage to the vertebrals
ataxia CNV-XII Swallowing Dizziness Nausea Dysarthria Nystagmus Facial sensory loss on same side
symptoms of damage to the basilar artery
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
Right hemisphere damage
Left hemiplegia Perceptual problems Often impulsive Lack of awareness of deficits Neglect
Left hemisphere damage
Motor and sensory losses Abnormal tone Depression and fatigue Emotional lability Right hemiplegia Cautious Slow movement Communication deficits
What do both right and left hemisphere damage share?
Motor and sensory losses
Abnormal tone
Depression and fatigue
Emotional lability
What type of stroke is more common
ischemic strokes
types of ischemic strokes
embolic
thrombotic
hypoxic
lacunar
what kind of stroke is more deadly but has a better recovery
hemorrhagic
types of hemorrhagic strokes
primary intercerebral
aneurysms
ateriovenous malformatins
describe embolic strokes
type of ischemic stroke
Most common of ischemic strokes
o Very quick onset
o Emboli usually arise in heart
describe thrombotic strokes
type of ischemic stroke
o Forms mostly at bifurcations
o Sudden onset or slower evolution
o Many times occurs during sleep
describe hypoxic strokes
type of ischemic stroke
due to shock, severe blood loss or cardiac arrest
describe lacunar strokes
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
desvribe primary intercerebral sto
type of hemorrhagic stroke
due to HTM
if bleed is > 5 cm there is too much herniation and prognosis is not good
describe aneurysms
type of hemorrhagic stroke
ballooining of vessel and thinning of the wall
can be congentital or degenerative
subarachnoid bleed can occur
describe an arteriovenous malformation
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
what is a subarachanoid bleed
usually a slower bleed aneurysm of the vein
prognosis is better than an aneurysm
What is a CVA
insufficient blood supply to the brain leading to death of neurons
What is a TIA
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
what is a RIND
reversible ischemic neurological deficit
resolves in > 24 hours but
typical problems and phenomenon of strokes
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
what is unilateral negelct
involuntary lack of attention to stimuli
often seen more often with right hemisphere damage
can be combined with homonymous hemianopsia
what is denervation supersenstivity
neurons become more sensitive to inputs
what is regenerative synaptogenesis
injured axons begin sproutingq
what is reactive synaptogenesis
collateral sprouting
neighboring normal axons sprout to innervate synaptic sites taht were previously atcivated by injured axons
What is the importance of these mechanisms?
neural plasticity
