Exam 1 - CN (medical aspects of stroke; site of lesion) Flashcards
Transient Ischemic Attack: traditional definition
a brief focal cerebral event in which symptoms develop suddenly; part of the brain has temporarily become ischemic; last 2 minutes to 24 hours
ischemic
lack of blood flow/O2
TIA: current definition
a transient episode of neurological interruption caused by temporary brain ischemia without acute infarction; duration is no longer specified
reversible ischemic neurological deficit (RIND)
stroke that gets completely better in 1-3 weeks
stroke
a sudden and severe onset of a prominent and frequently persistent neurological deficit; an illness resulting from damage to the parenchyma of the brain; brain death occurs (infarction)
parenchyma
tissue
black spot on CT scan =
dead tissue
two types of strokes
- occlusive (ischemic)
- hemorrhagic
2 causes of occlusive strokes
- thrombotic occlusion of artery
- embolic occlusion of artery
85% of strokes
occlusive
occlusive =
ischemic
ischemic =
occlusive
occlusive stroke
blockage that causes low blood flow to the brain
thrombosis
stationary blockage along an arterial wall (narrows artery)
embolus
particle that breaks away/floats around in bloodstream
15% of strokes
hemorrhagic
hemorrhagic stroke
rupture of blood vessel anywhere within skull or brain
bleeding from a complex of abnormally formed vessels
hemorrhagic stroke
arteriovenous malformation
abnormally formed blood vessels
hemorrhagic strokes can occur within 4 different spaces:
- intracerebral
(intracranial) - subarachnoid
- subdural
- epidural space
intracerebral hemorrhagic stroke
parenchyma of brain
somewhere inside skull
intracranial hemorrhagic stroke
subarachnoid space
subdural space
epidural space
subarachnoid hemorrhagic stroke
intracranial
between pia and arachnoid mater
subdural hemorrhagic stroke
intracranial
between arachnoid and dura mater
epidural hemorrhagic stroke
intracranial
between dura mater and skull
order of mater outside -> inside
dura mater
arachnoid mater
pia mater
meninges are composed of
dura, arachnoid, and pia mater
which artery supplies the brainstem?
basilar artery
which artery supplies the cerebellum?
basilar artery
main branches of the vertebral arteries (back)
- basilar artery
- posterior cerebral arteries
which artery supplies the occipital cortex?
posterior cerebral artery (PCA)
which artery supplies the thalamus?
PCA
which artery supplies the internal capsule?
PCA
where does the thalamus sit?
on top of brainstem
branches of the internal carotid arteries?
- anterior cerebral artery (ACA)
- middle cerebral artery (MCA)
which artery supplies the anterior and middle portions of the brain?
ACA
which artery supplies the frontal and parietal lobes?
ACA
artery of most common stroke?
MCA
which artery supplies the lateral surfaces (sides) of the cerebrum?
MCA
if anterior lesion,
nonfluent aphasia
site of lesion that affects motor (output)
anterior
if posterior lesion,
fluent aphasia
site of lesion that affects sensory (input)
posterior
If lesion in supramarginal gyrus, angular gyrus, and/or arcuate fasciculus, then possibly
conduction aphasia
possible sites of lesion for conduction aphasia
supramarginal gyrus, angular gyrus, &/or arcuate fasciculus
if lesion in deep white matter parietal region, then
transcortical sensory aphasia
site of lesion for transcortical sensory aphasia,
deep white matter of parietal region
if anterior AND posterior lesion, then
global aphasia
global aphasia sites
anterior AND posterior lesions
if lesion in parietal or frontal regions, then
anomic aphasia
anomic aphasia lesion site
parietal or frontal lobes
anterior =
(motor or sensory)
motor
posterior =
(motor or sensory)
sensory
front region =
anterior
back region =
posterior
output
anterior
input
posterior
nonfluent
output/anterior/motor
fluent
input/posterior/sensory
% of pop that is left brain dominant for language
95%
best Tx for stroke
prevention
corpus callosum allows
left and right brain to communicate
public education about a “brain attack” (stroke)
signs & symptoms
FAST (face, arms, speech, time)
FDA approved Tx for stroke
- mechanical thrombectomy or embolectomy devices
- clot-busting drugs
- stent
experimental Tx for stroke
- DSPA (bats)
- nanobubbles
- transnasal drugs
- vagus nerve stimulation
tPA cannot be given if
a person is already on blood thinners
must administer tPA w/in
4.5 hours of onset of symptoms
“mohawk” part of brain
ACA