Neurological and Endocrine Disorders

Question 1

What is a cerebrovascular accident (CVA)?

Answer 1

A cerebrovascular accident (CVA) is also known as a stroke and is caused by a sudden interruption of blood flow to the brain that causes a loss in neurological functioning.

Question 2

What is the leading risk factor for a stroke?

Answer 2

The leading risk factor for a stroke is hypertension.

Question 3

List other risk factors for a stroke.

Answer 3

Atherosclerosis (hardening of the arteries), heart disease, diabetes, cigarette smoking, heavy alcohol consumption, obesity, older age, male gender, African American race, and a family history of stroke.

Question 4

What are the two main types of stroke?

Answer 4

The two main types of stroke are ischemic stroke and hemorrhagic stroke.

Question 5

What is an ischemic stroke?

Answer 5

An ischemic stroke occurs when there is blockage in a cerebral artery that is due to a blood clot that developed in an artery in the brain (thrombotic stroke) or that developed in the heart or elsewhere in the body and traveled through the bloodstream to the brain (embolic stroke).

Question 6

What is a transient ischemic stroke (TIA)?

Answer 6

A blockage of an artery for less than five minutes that causes temporary symptoms is referred to as a transient ischemic stroke (TIA). TIAs are medical emergencies and are a warning sign that a more severe stroke may occur in the future.

Question 7

What is a hemorrhagic stroke?

Answer 7

A hemorrhagic stroke is due to bleeding that occurs when there is a rupture in a cerebral artery within the brain (intracerebral hemorrhage) or in the space between the brain and the membrane that covers the brain (subarachnoid hemorrhage).

Question 8

What are the symptoms of a stroke involving the middle cerebral artery?

Answer 8

Contralateral sensory loss, contralateral hemiparesis (weakness) or hemiplegia (paralysis), contralateral homonymous hemianopsia (visual field loss), dysarthria (slurred speech), and aphasia when the dominant hemisphere is affected or apraxia and contralateral neglect when the nondominant hemisphere is affected.

Question 9

What are the symptoms of a stroke involving the posterior cerebral artery?

Answer 9

Contralateral sensory loss and hemiparesis, contralateral homonymous hemianopsia or other visual impairment, dysarthria, nausea and vomiting, and memory loss.

Question 10

What are the two main types of traumatic brain injury (TBI)?

Answer 10

The two main types of TBI are open (penetrating) head injuries and closed head injuries.

Question 10

What are the symptoms of a stroke involving the anterior cerebral artery?

Answer 10

Contralateral sensory loss and hemiparesis (especially in the leg), impaired insight and judgment, mutism, apathy, confusion, and urinary incontinence.

Question 11

How do open and closed head injuries differ in terms of damage?

Answer 11

Closed head injuries usually cause more widespread damage than open head injuries do.

Question 12

What are some cognitive symptoms of TBI?

Answer 12

Cognitive symptoms of TBI may include some degree of anterograde and retrograde amnesia.

Question 13

What is anterograde amnesia in the context of TBI?

Answer 13

Anterograde amnesia, also known as post-traumatic amnesia when due to TBI, is the inability to form new memories following the injury. Its duration is a good predictor of recovery from other symptoms.

Question 14

How does retrograde amnesia affect memories in TBI?

Answer 14

When retrograde amnesia occurs, recent long-term memories are affected more than remote memories; and, when lost memories begin to return, those from the most distant past are recovered first.

Question 15

List other symptoms of TBI.

Answer 15

Nausea and vomiting, headaches, sleep disturbances (e.g., hypersomnia or insomnia), depression, irritability, aprosodia, and seizures.

Question 16

What is aprosodia, and what can cause it?

Answer 16

Aprosodia is the inability to express or understand prosody, which refers to variations in the rhythm, pitch, timing, and loudness of speech that are used to convey emotional information. It can occur as the result of a TBI, stroke, or progressive neurologic disease.

Question 17

What are post-traumatic seizures (PTS), and how are they treated?

Answer 17

Post-traumatic seizures (PTS) occur within one week after TBI and can often be successfully treated with anti-seizure medication.

Question 18

What is post-traumatic epilepsy (PTE), and how is it treated?

Answer 18

When seizures occur more than one week after TBI, they are classified as post-traumatic epilepsy (PTE). PTE is harder to treat than PTS, with vagus nerve stimulation (VNS), responsive neurostimulation (RNS), or surgery being considered when medication is ineffective.

Question 19

What is the general prognosis for recovery from TBI?

Answer 19

Most people experience the most recovery from TBI during the first three months with substantial additional improvement during the first year. However, many people continue to have some symptoms indefinitely, especially those with a moderate to severe injury.