Lecture 5 - Cerebrovascular disease

Question 1

What are acute signs of a stroke?

Answer 1

Headache, loss of mental abilities, loss of strength/paralysis, confusion and disorientation

Question 2

What are the two major risk factors of getting a stroke?

Answer 2

Being over 65 and hypertension (also things like smoking, previous cardiovascular related diseases, lack of exercise, etc.)

Question 3

There are two types of strokes, which ones are these and what do they mean?

Answer 3

Ischemic stroke (infarct) > blockage of the artery = decreased or no oxygen to a part of the brain

Hemorrhagic stroke > rupture of an artery = bleeding in the brain

Question 4

Which type of stroke is more common?

Answer 4

Ischemic stroke (circa 80% of cases)

Question 5

What are the main risk factors/causes for a cerebral hemorrhage?

Answer 5

Age and hypertension, but also things like a TBI, tumours, degenerative conditions or arteriovenous malformetion

Question 6

What is a Subarachnoidal haemorrhage (sah), cause and what does the treatment entail?

Answer 6

This is outside the brain between the arachnoids and the pressure may lead to dwamage. Most common cause is a burst aneurysm and treatment involves a catheter with coils to fill the aneurysm sac (“coiling”) or clipping with a metal thing

Question 7

What entails the acute treatment of a heamorrhage?

Answer 7

Generally conservative (they hope the bleeding stops mostly by itself), medication to reduce welling and surgery to relieve pressure on the brain

Question 8

An infarction usually happens in which three arteries?

Answer 8

Middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA)

Question 9

What does the acute treatment of an infarct entail?

Answer 9

Thrombolyse (drug injection to dissolve cloth) or thrombectomy (catheter removal of cloth)

Question 10

What brain areas are affected when the medial cerebral artery has a cloth?

Answer 10

Frontal, temporal and parietal areas of the brain

Question 11

What conditions/complications can one expect when an infarct happens within the MCA

Answer 11

Memory problems (anterograde), apraxia (inability to carry out meaningful interactions), aphasia (usually if infarct on left), neglect (usually if infarct on right)

Question 12

What conditions/complications can one expect when an infarct happens within the PCA

Answer 12

Hemianopsia (half of the visual field = goodbye), visual agnosia (can’t derive meaning from seen objects), prosopagnosia (can’t recognize familiar faces)

Question 13

What brain areas are affected when the PCA has a cloth?

Answer 13

occipital lobe and temporal lobe

Question 14

What brain areas are affected when the ACA has a cloth?

Answer 14

dorsal and medial parts of the frontal and parietal lobes

Question 15

What conditions/complications can one expect when an infarct happens within the ACA

Answer 15

impairments of the executive functions and social cognition

Question 16

What’s a lacunar infarct?

Answer 16

In the white matter > causes a range of complaints like memory and attention

Question 17

What’s a transient ischemic attack (tia)?

Answer 17

an “ischemic attack” where the symptoms disappear within the hour > larger risk for an infarct

Question 18

What problems arise when the cerebellum is affected?

Answer 18

cognitive and emotional problems

Question 19

There are emotional consequences to cerebrovascular diseases, what trend do these see?

Answer 19

An increasing trend after the months following the incident