Lecture 5: Stroke 2 Flashcards
which gyrus is motor
precentral gyrus
which gyrus is sensory
post central gyrus
which three ways can the brain show injury
decreased loss of consciousness, seizures, and localizing signs ( hemiparesis, hemiplegia, dysphasia, visual disturbances, etc)
common symptoms of acute stroke are usually
sudden
what are the most common areas that are affected by stroke
face, arm, or leg; brain; eyes; stomach; body; legs
deficits to this part of the brain include: paralysis, inability to sequence a task/plan, eye movements, personality changes, difficulty with prob solving, changes in social behavior, and inability to express language ( Brocas Area)
frontal lobe deficits
deficits to this lobe include : inability to name an object, difficulty reading, difficulty with hand eye coordination, difficulty drawing objects, sensory defects, and akinetopsia
parietal lobe deficits
what is it called when the image is not continuous but choppy and you get glimpses of images
akinetopsia
deficits to this pt of the brain include: trouble recognizing faces, short and longterm memory defects, hearing probs, increased aggressive behavior, visual field defects, trouble understanding spoken words, increased or decreased interest in sexual behavior
temporal lobe defects
deficits to this lobe involve visual changes: hemianopia, Quadrantanopsia, visual field defects, color recognition, trouble reading and writing, trouble recognizing drawn objects, diplopia, vertigo, dizziness
occipital lobe defects
what are the two types of hemispherical strokes that affect visual field
homonymous hemianopsia and hemispatial neglect
what is loss of half the field of vision in each eye
homonymous hemianopsia
what is technically not a vision problem, and is the inability to attend to one side of the world
hemispatial neglect
what are the side effects of left hemisphere stroke
aphasia ( dysarthria - speakinh ), right hemiparesis, right sided sensory loss, right visual field defect, poor right conjugate gaze, trouble reading, writing, or calculatin
what are the side effects of right hemisphere stroke
left neglect, defect of L visual field, left hemiparesis, left sided sensory loss, poor L conjugate gaze, dysarthria, spatial disorientation
what is disorder of speech called
dysarthria -> imperfect articulation of speech sounds, changes in voice pitch or quality
what is the inability to comprehend, integrate, and express language
aphasia-> affects 34-38% of stroke pts , of that 1/2 have resolve on their own
what are the two types of aphasia
receptive ( fluent ) and expressive ( non fluent)
what type of aphasia is when someone can internally think what they want to say but it comes out as jibberish
receptive aphasia
what type of aphasia is when a person can understand what you are saying but cant answer them properly
expressive aphasia
what are common signs of cerebellar stroke
vertigo, HA , vomiting, ataxia ( coordination probs, inability to walk, inability to reach out and grab objects
what is the most common stroke area of the cerebellum
posterior inferior cerebellar artery
brain stem strokes involves…
cranial nuclei and long tracts
what usually occurs with cranial nuclei in brain stem strokes
diplopia
what happens with pure motor ( long tracts) in brain stem strokes
weakness of the face and limbs on one side of the body; no higher brain function, sensation, or vision deficits
what happens with pure sensory in brain stem strokes
decreased sensation of face and limbs on one side of body; no higher brain function , motor, or vision deficits
what is the most common vessel involved with stroke
middle cerebral artery
what signs do you check for stroke
Face, Arm, Speech, Time ( FAST)
what is the Cincinnati prehospital stroke scale
have pt smile ( facial droop); have pt close eyes and hold arms out ( arm drift ); have pt say “: you cant teach an old dog new tricks ( speech)
what test can confirm the dx of stroke and tell whether the stroke is caused by hemorrhage in the brain
CT scan
what test can identify and further localize the site of the stroke and find the source
MRI/MRA
what can pinpoint the exact location of blockage or bleeding in the brain ; historical gold standard; replaced by CTA/ MRA
Angiography
what are the two types of hematomas
subdural and epidural
which hematoma is usually due to trauma
subdural
which hematoma has a crescent shape in CT scan
subdural
which hematoma has a lenticular shape in CT scan
epidural
in what type of stroke does the denseness of blood change over time ( gets darker as it goes from acute- subacute- chronic)
hemorrhagic
In a CT scan which color represents low blood flow areas
purple
which test allows for good soft tissue differentation and we use it to look at the arteries, the downside is its expensive and takes a long time
MRI
which test allows for good view of the vessels
MRA
what is an effective ischemic stroke tx
tissue plasminogen activator
what does tissue plasminogen activator do
IV; dissolves the clot; restores some blood flow; can cause hemorrhaging; must be admin. within 3 hours of symptom onset ( only 1-7 % receive this therapy bc its hard to get people in hospital in 3 hours )
what are some hemorrhagic stroke tx
surgery, control of bp, discontinue anticoagulant therapy
what is the number one thing we can do to prevent stroke
HTN
what is the survival rate of stroke
50%
what is the rule of thirds of stroke
1/3 recover with no or minimal disability; 1/3 recover with residual disability; and a 1/3 die
what is the human cost of stroke among survivors
some require daily assistance, some need help walking, some live permanently in nursing homes, and some are work impaired
