Lecture 16: Stroke Treatment

Question 1

Three majors arteries of brain; why they are important

Answer 1

1. Anterior cerebral
2. Middle cerebral
3. Posterior cerebral
   - important because they supply blood to the brain
   - blockage to any of the arteries can result in loss of sensory functions (speech, motor skills, movement, etc.)

Question 2

Roll of middle cerebral artery

Answer 2

• supplies much of the blood to brain
• largest cerebral artery and most commonly associated with stroke
• if there is blockage, only 1/2 of brain will be affected because MCA is on both sides of the brain

Question 3

Why is time so important in the context of strokes?

Answer 3

• important because neurons die quickly (1.9 million neurons per minute while stroke left untreated
• one hour of untreated stroke results in brain aging 3.6 years per hour

Question 4

Hemiplegia

Answer 4

• paralysis on one side of body
• result of disrupted blood flow
• damage on left side affects right side and vice versa
• affects face, body, brain, or spine

Question 5

Symptoms of Stroke

Answer 5

-Act FAST:

1. Face droops on one side
2. Arms can’t be held up as high
3. Speech is slurred
4. Time to call 911

-sloppy texting could be a symptom (dystexia)

Question 6

Lasting effects of stroke

Answer 6

• muscle weakness or paralysis esp. on one side of body
• speech and language problems
• problems with memory and thinking
• problems with vision, swallowing, and controlling bowel movements
• excessive tiredness

Question 7

Detection devices for strokes

Answer 7

• CT scanner to look inside of brain for hemorrhaging (can tell difference between ischemic and hemorrhagic strokes)
• Hemorrhagic has bright white spots (blood), and ischemic has dark spots (death cells)
• CT scanner good because looks inside of body instead of outside like X-ray
• MRI machine: shows images of the brain tissue

Question 8

Catheter-directed thrombosis

Answer 8

• for ischemic stroke
• a catheter is place up the leg into the appropriate artery where anti-coagulate drugs are injected right where the clot is
• good because it injects drugs right at the source of the clot

Question 9

MERCI

Answer 9

• Mechanical Embolus Removal in Cerebral Ischemia
• for ischemic stroke
• device is injected directly into artery to remove a blood clot in order to restore blood flow
• 1st stroke thrombectomy device to be approved by FDA in 2004

Question 10

Aneurysm

Answer 10

• A balloon-like bulge of an artery wall
• as aneurysm forms, it causes pressure leading to neurological symptoms (e.g. headaches); good in a way because it causes people to go to the doctor
• Two treatments: aneurysm clipping and coil embolization

Question 11

Aneurysm Clipping

Answer 11

• for hemorrhagic stroke
• clip is placed on the base of the aneurysm to prevent more blood from entering in ballon, which could lead to it bursting
• craniology is performed

Question 12

Coil Embolization

Answer 12

• for hemorrhagic stroke
• catheter is inserted in aneurysm where soft metal coils are inserted to fill up space of ballon
• used to prevent more blood from entering in ballon, which could lead to it bursting
• causes scar tissue to form and closes aneurysm