Neurological And Endocrine Disorders Flashcards
Cerebrovascular accident
- stroke
- sudden disruption of blood flow to the brain that causes loss and neurological functioning
Risk factors of a cerebrovascular accident
- leading risk factor is hypertension
-atherosclerosis (artery hardening)
- heart disease
- diabetes
- cigarette smoking
- heavy alcohol consumption
- obesity
- age
- male gender
- black
- family history of stroke
Types of cerebral vascular accident
- ischemic stroke
- embolic stroke
Ischemic stroke
- most common
- blood clots or other particles block the blood vessels to the brain
Thrombotic stroke
- blockage in the cerebral artery due to a blood clot that developed in an artery in the brain
Embolic stroke
- blockage in the cerebral artery due to a blood caught that developed in the heart or elsewhere in the body and traveled through the bloodstream to the brain
Transient ischemic stroke (TIA)
- blockage of an artery for less than 5 minutes that causes temporary symptoms
- medical emergencies and warning signs for more severe strokes in the future
Hemorrhagic stroke
- due to bleeding that occurs when there is a leaker rupture
Intercerebral hemorrhage
- rupture in a cerebral artery within the brain
SubArachnoid hemorrhage
- rupture in the space between the brain and the membrane that covers the brain
Symptoms of a stroke
- depend on the artery involved
Middle cerebral artery stroke
- usually involved
- contralateral sensory loss
,-contralateral hemiparesis (weakness)
- hemiplegia (paralysis)
- contralateral homonymous
hemianospsia (visual field loss)
-dysarthria (slurred speech)
- aphasia(when dominant hemisphere is affected)
- apraxia and contralateral neglect (non-dominant hemi)
Sxs of Stroke involving posterior cerebral artery
- contralateral sensory loss
- hemiparesis
- contralateral homonymous hemianospsia or other visual impairment
-dysarthria
- nausea and vomiting
- memory loss
Sxs of a stroke involving the anterior cerebral artery
- contralateral sensory loss
- hemiparesis (usually leg)
- impaired insight and judgment
- mutism
- apathy
- confusion
- urinary incontinence
Traumatic brain injury
- Open
- closed
Open TBI
- penetrating head injury
- depend on injuries location in severity
Closed head injuries
- usually cause more widespread damage
TBI symptoms
- loss of consciousness
- anterograde or retrograde amnesia
- nausea and vomiting
- headaches
- sleep disturbances
- depression
- irritability
- aprosodia
- seizures
Anterior grade amnesia
- post-traumatic amnesia when do the TBI
- a good predictor of recovery from other symptoms
Retrograde amnesia
- recent long-term memories are affected more than remote memories
- when lost memories, return those from the most distant past are recovered first
Aprosodia
- kind of car as a result of a TBI, stroke, a progressive neurological disease
- inability to express or understand prosody (variations in rhythm, pitch, timing, and loudness of speech that are used to convey emotional information)
Post-traumatic seizures( PTS)
- occur within one week after TBI
- can be successfully treated with anti-seizure medications
Post-traumatic epilepsy (PTE)
- seizures that occur more than a week after a TBI
- harder to treat
- treatment:
- Vagus nerve stimulation
- Responsive neurostimulation
- Surgery when medication is ineffective
Seizures after TBI
- some evidence that they’re linked to temporal lobe and hippocampal atrophy
Prognosis of TBI
- most recovery during the first 3 months
- substantial additional improvement during first year
- many people continue to have symptoms indefinitely, especially those with moderate to severe injury
Huntington’s disease
- neurodegenerative disorder
- affect, cognitive, and motor symptoms
- caused by an autosomal dominant gene= offspring has a 50% chance of inheritance
- abnormalities in the basal ganglia and abnormal levels of gaba and glutamate
Onset of Huntington’s disease
- 30 to 50 years old
Prognosis of Huntington’s disease
-varies
- effective symptoms often proceed cognitive and motor symptoms
(Manifestation of underlying pathological changes) - as disease progresses, effective, cognitive, and motor symptoms worsen with atheotosis & chorea beginning several years after onset.
- and the later stages, movement disorders are severe, and the person may have trouble speaking, swallowing and may meet the criteria for major or mild NCD
symptoms of Huntington’s disease
- short-term memory loss
- impaired concentration and judgment
- clumsiness
- fidgeting
- involuntary movements
- facial grimacing
Athetosis
- non-Rhythmic, slow, weathering movements
Chorea
- involuntary rapid, jerky, movements in the arms, legs, & trunk
Parkinson’s disease
- neurodegenerative disorder
- produces prominent motor symptoms
- interaction between genetic factors and environmental risk factors
Neurotransmitters and Parkinson’s disease
- loss of dopamine producing cells in a substantial negra and basal ganglia cause motor symptoms
- excessive glutamate activity and basalgamia is implicated in the progression of the disease
- the generation of norepinephrine neurons in the locus cerelius is responsible from non-motor symptoms (depression, cognitive deficits, and sleep disturbances)
Genetics and Parkinson’s disease
-variants of ApoE gene linked to increased risk of NCD due to Parkinson’s disease and other NCDs including NCD due to Alzheimer’s, lewy bodies, and vascular neurocognitive disorder
Primary motor symptoms of Parkinson’s disease
- tremor: when muscles are at rest and begins in hands and includes pill rolling
- impaired balance and coordination
- rigidity and limbs and trunk
- slowed voluntary movements (bradykinesia) that include a mask like facial expression and decreased eye blink frequency
Depression and Parkinson’s disease
- up to 50% of people experience depression at some time during the disorder
- depressive symptoms proceed motor symptoms in about 20% of cases
NCD and Parkinson’s disease
- people eventually developed milder major NCD
Treatment of Parkinson’s disease
- no cure
- symptoms or temporary alleviated in early stages with L-dopa (+ dopamine)
- deep brain stimulation (DBS) used to reduce motor symptoms