CVA Flashcards
Expected possible impairment with….
- Anterior cerebral artery
- Contralateral LE motor and sensory involvement
- loss of bowel and bladder control
- loss of behavioral inhibition
- significant mental chnages
- neglect
- aphasia
- apraxia and agraphia
- perseveration
- akinetic mutism with significant bilateral involvement
Expected possible impairment with….
- middle cerebral artery
- most COMMON site of CVA
- wernicke’s aphasia in dominant hemisphere
- homonymous hemianopsia
- apraxia
- flat affect with right hemisphere damage
- contralateral weakness and sensory loss of face and upper extremity with lesser involvement in the LE
- impaired spatial relations
- anosognosia in non-dominant hemisphere
- impaired body schema
What area of the brain does ACA serve?
- anterior frontal lobe
- medial surface of frontal and parietal lobes
What area of the brain does MCA serve?
- most of outer cerebrum
- basal ganglia
- posterior and anterior internal capsule
- putamen
- pallidum
- lentiform nucleus
What area of the brain does PCA serve?
- Portion of midbrain
- subthalamic nucleus
- basal nucleus
- thalamus
- inferior temporal lobe
- occipital and occipitoparietal cortices
Expected possible impairment with….
PCA
- contralateral pain and temp sensory loss
- contralateral hemiplegia (central area), mild hemiparesis
- ataxia, athetosis, or choreform movement
- quality of movement is impaired
- thalamic pain syndrome
- anomia
- prosopagnosia with occipital infarct
- hemiballismus
- visual agnosia
- homonymous hemianopsia
- memory impairment
- alexia, dyslexia
- cortical blindness from bilateral involvement
What are of the brain does the vertebral-basilar artery serve?
- lateral aspects of pons and midbrain with superior surface of cerebellum
- cerebellum: branches from the basilar artery (PICA, AICA, SCA
- medulla: PICA
- Pons: branches from basilar
- midbrain and thalamus: PCA
- occipital cortex: PCA and basilar artery
Expected possible impairment with….
vertebral- basilar artery
- LOC
- Hemiplegia or tetraplegia
- comatose or vegetative state
- inability to speak
- locked-in syndrome
- vertigo
- nystagmus
- dysphagia
- dysarthria
- syncope
- ataxia
Locked- in syndrome
is a condition in which a patient is aware but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for vertical eye movements and blinking.
Wallenberg syndrome secondary to lateral medullary infarct
- can develop when damage occurs in a part of the brainstem called the lateral medulla.
-Hoarseness
Dizziness, nausea, and vomiting
Rapid involuntary eye movements
Difficulty with balance and gait coordination
Problems with body temperature sensation
**Lack of pain and temperature sensation on one side of the face, or different symptoms on each side of the body
Uncontrollable hiccups
Loss of taste on one side of the tongue
Decreased sweating
Changes in heart rate and blood pressure
Primary risk for CVa
- HTN
- Cardiac disease or arrhythmias
- DM
- smoking
- TIA
Secondary risk factors for CVA
- Obesity
- High cholesterol
- stress, excessive salt intake
- physical inactivity
- incr alcohol consumption
Transient ischemic attack TIA
- usually linked to an atherosclerotic thrombosis which causes a temporary interruption of blood supply to an area of the brain
- similar to CVA but symptoms resolve quickly within 24 to 48 hours
- often occurs in the carotid and vertobrobasilar arteries
stroke in evolution
- CVa usually caused by a thrombus that gradually progresses
- total neurological deficts ar enot seen for one to two days after onset
ischemic stroke
- embolus
- may be a solid, liquid or gas and can originate in any part of the body. Occurs rapidly with no warning
- travels through body causing occlusion of a blood vessel and a resultant infarct
- MCA is most commonly affected by an embolus from the ICA
- tissues distal to infarct can sustain higher permanent damage than those of thrombotic infarct.
