Etiologies of Neurogenic Communication Disorders, Part 1 Flashcards
What are 7 neurogenic communication disorders?
- Cerebrovascular Disorders
- Traumatic Brain Injury
- Epilepsy
- Multiple Sclerosis
- Parkinson’s Disease
- Huntington’s Disease
- Alzheimer’s Disease
What are Cerebrovascular disorders?
Any abnormality of brain resulting from pathologic
process of blood vessels
What is a stroke (CVA)?
The sudden appearance of neurologic symptoms as a result of severe interruption of blood flow
What are some acute symptoms may occur from a stroke? (8)
weakness (esp.hemiparesis),
paralysis (esp. hemiplegia),
dizziness,
confusion,
headache,
visual disturbance (esp. hemianopia),
aphasia,
dysarthria
In strokes, impairments reflect both __________ and _______ of a stroke
location and size
Strokes make up _____% of neurologic disorders seen in general hospital.
> 50%
What is and ischemic stroke?
CVA from a blocked blood vessel (approx 80% of all strokes)
What occurs from a stroke with thrombosis?
Artery is gradually occluded by
accumulation of material at a given site
What occurs from a stroke with embolism?
Artery is suddenly occluded by material that travelled to that site from a larger vessel
What is an infarct?
Area of dead tissue (necrosis) a result of a stroke
What is a tPA?
Tissue Plasminogen Activator
What is TIA?
Transient Ischemic Attack
What are the characteristics of TIA? (4)
–“Mini Stroke”
–Increases stroke risk
–Caused by temporary interruption of blood
supply to brain (from small embolus, partial
stenosis, or vasospasm)
–Similar symptoms to ischemic stroke but
typically last < 5 min with complete recovery
Which artery supplies most communicative areas in the brain?
Middle Cerebral Artery
What is occurring in this CT scan?
What is occurring in this CT scan?
What is occurring in this CT scan?
What is an Hemorrhagic stroke?
Occurs when blood vessel in or around the brain ruptures, spilling blood into the brain or the area surrounding the brain
What are the two types of strokes?
Ischemic (80% of all strokes)
Hemorrhagic (20% of all strokes)
What occurs in this CT scan?
What is a TBI?
Traumatic Brain Injury
What can cause a TBI?
Strong external force applied to head (moving
head strikes stationary object, or vice versa
What can cause a TBI?
Strong external force applied to head (moving
head strikes stationary object, or vice versa
What is the most common cause of brain damage in people < 40 years?
TBI
True or False: TBI can result from vehicle accidents, falls and sports
True
What are key factors in TBI? (2)
Age and gender
True or False: One TBI increases risk of more
True
True or False: The effects of TBI can’t be cumulative
False, e.g., Dementia Pugilistica
What are open head injuries?
Skull is crushed or penetrated by
foreign object (e.g., bullet), or
fragments of bone
What accounts for a majority of fatalities following head trauma?
Open Head Injuries
Explain the outcomes of survivors from OHI.
Outcomes vary but some survivors remain conscious and have relatively good recoveries with only focal impairments
Symptoms of OHI depend on ___________ of injury
(e.g., ___________,
__________, ___________, ____________)
Location
hemiplegia
hemianopia
aphasia
hearing loss
What are three primary injuries of OHI? (3)
- Destruction of brain tissue at site of entry and along path of object
- Damage to meninges
- Intracranial bleeding due to damaged blood
vessels
What are five potential secondary effects of OHI? (5)
- Destruction of brain tissue during surgical removal of foreign object
- Ischemia (i.e., interruption of blood flow to tissue)
- Edema (i.e., reactive swelling of brain tissue)
- Brain infection
- Post-traumatic epilepsy
What are characteristics of Closed Head Injury? (3)
- Blow to head which subjects brain to variety
of mechanical forces - Skull remains relatively intact
- Acceleration vs. non-acceleration injuries
What occurs in this effect of primary injuries of CHI?
Brain contusions are typically seen at site of impact (i.e., coup lesion). As well, pressure during impact causes brain to hit opposite side of skull (i.e., contrecoup lesion).
What occurs in this effect of primary injuries of CHI?
The orbitofrontal and anterior temporal regions
are the most common sites of contusion and are
caused by the brain rubbing against the base of
the skull.
What are 6 secondary effects of CHI?
- Edema
- Hydrocephalus
- Damage to major fiber tracts (diffuse microscopic lesions)
- Post Traumatic Epilepsy
- Ischemic Brain damage
- Intracranial and Extracerebral Bleeding
What occurs in this effect of primary injuries of CHI? (2)
Diffuse microscopic lesions that result from twisting or shearing of neurons (known as diffuse axonal injury). May be responsible for persistent neurologic deficits.
* Damage to major fiber tracts
(e.g., corpus callosum)
What are behavioral effects of TBI? (4)
- Discrete impairment of those functions mediated by
site of contusion (esp. executive system dysfunction
from prefrontal damage) - But also more generalized impairment from widespread neuronal damage (e.g., decrease in
mental speed, concentration, cognitive efficiency) - TBI severity varies markedly
- Recovery varies markedly
What is this potential secondary effect of CHI?
Edema (i.e., reactive swelling of brain tissue and collection of fluid). Increases intracranial pressure
What is this potential secondary effect of CHI?
Intracranial bleeding (i.e., hemorrhage) which may become a semisolid, localized mass (i.e., hematoma)
What occurs in this effect of primary injuries of CHI?
Extracerebral bleeding
What occurs in this effect of primary injuries of CHI?
Hydrocephalus (i.e., disturbed flow and excessive accumulation of CSF resulting in dilation of ventricles and raised intracerebral pressure)
Hydrocephalus can cause : (2)
- Ischemic brain damage
- Post-traumatic epilepsy
Which surface of the cortex does the MCA irrigates?
The Lateral surface of the cortex
What is Epilepsy?
Sudden, brief attacks that may alter motor, sensory experiences and levels of consciousness
What causes Epilepsy in the brain?
Caused by abnormal electrical discharges in gray matter of brain
1/___ will experience at least 1 seizure in lifetime
1/20
1/_____ will develop chronic seizure disorder
200
________________ seizures develop spontaneously without other neurologic disorders
Idiopathic seizures
_____________ seizures can be identified with a
specific cause (e.g., trauma, tumor)
Symptomatic seizures
What are the two types of Epilepsy?
Partial/Focal seizures
Generalized seizures
What are 4 characteristics of partial/ Focal Seizures?
- Occur in 2/3 patients with epilepsy
- Begin in one part of brain and might spread to other regions
- In simple-partial seizures, there is no alteration in consciousness
- In complex-partial seizures, consciousness is
impaired
Complex-partial seizures usually originates in which lobe?
Usually originates in temporal lobe
With what complex-partial seizures may be associated with? (2)
Ongoing cognitive and emotional difficulties
Complex-partial seizures may cause: (4)
absences,
hallucinations,
affective symptoms,
automatisms
What are characteristics of Generalized Seizures? (2)
Occur in 1/3 patients with epilepsy
Bilaterally symmetrical without focal onset
(e.g., tonic-clonic seizures)
What is occurring between these two types of seizures?
On the left: There is a focal seizure since there is an electrical surge at few electrode.
On the right: There is a generalized seizure since all electrodes of the EEG show an electrical surge in the brain.
What are two ways to treat Epilepsy?
Pharmacotherapy
Surgery
In Pharmacotherapy, __________________ drugs control seizures in about ____% of patients
Anticonvulsant drugs control seizures in about
70% of patients
What are two characteristics of surgeries to treat epilepsy?
– Seizures need to originate from focal area and
interfere significantly with patient’s functioning
& quality of life
– May be associated with post-surgical cognitive
deficits
Complex-partial seizures usually originates in which lobe?
Usually originates in temporal lobe
Complex-partial seizures usually originates in which lobe?
Usually originates in temporal lobe
