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Clinical & Neuropsychology > NP: Lecture 5 Cerebrovascular diseases > Flashcards

NP: Lecture 5 Cerebrovascular diseases Flashcards

1
Q

4 sudden onset symptoms of a stroke

A

headache
loss of mental abilities
loss of strenght/paralysis
confusioon, disorientation, consciousness

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2
Q

wat voor scan bij stroke

A

ct scan, voor verschil tussen hemmorhage en infarct -> blood shows up white on normal ct

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3
Q

prevalence stroke worldwide

A

a stroke every 2 seconds

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4
Q

hoeveel strokes per jaar in nl

A

40.000

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5
Q

hoeveel stroke survivors in nl

A

200.000

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6
Q

wat hebben de survivors vaak als symptomen

A

chronic deficits and complaints

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7
Q

number of survivors are increasing due to…

A

better treatment and increased prevalence -> higher life expectancy

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8
Q

stroke is an age related disease but…

A

young strokes (between 18-50) are increasing

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9
Q

ethiology of strokes

A
  • ischaemic stroke/infarct
  • heamorrhage stroke
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10
Q

hoeveel % ischaemic stroke

A

80%

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11
Q

hoeveel % haemorrhage stroke

A

20%

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12
Q

ischaemic stroke =

A

obstruction blocks blood flow -> area is deprived of blood

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13
Q

haemorrhage stroke =

A

weakened vessel wall ruptures, causing bleeding in the brain

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14
Q

infarcten verschillende prevalentie

A

arteria cerebri media = 80%
arteria cerebri posterior = 10%
arteria cerebri anterior =3%
small lacunar infarcts (in white matter)

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15
Q

infarct =

A

afsterven weefsel

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16
Q

mild form of infarct

A

transient ischemic attack = TIA

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17
Q

wat is kenmerkend van een tia

A

de symptoms dissapear within an hour

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18
Q

infarct acute treatment

A
  • thrombolyse
  • thrombectomy
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19
Q

thrombolyse =

A

tissue plasminogen activator geven, lost de bloodclot op

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20
Q

within …. after onset moet thrombolyse gedaan worden

A

within 4 hours

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21
Q

thrombectomy

A

removal of the brain clot with a catheter

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22
Q

cerebral haemorrhages occur more in older ppl with …

A

high blood pressure

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23
Q

intracranial bleeding can also occur after…

A
  • traumatic brain injury
  • tumour
  • degenerative conditions (amyloid, dementia)
  • arteriovenous malformation
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24
Q

haemorrhage acute treatment

A

acute treatment is often conservative
medication to reduce swelling
surgery to relieve pressure on the brain

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25
Q

subarachnoidal heamorrhage

A

outside brain, in cavity between arachnoids
pressure on the brain may lead to damage
most frequent cause: aneurysm

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26
Q

2 treatments subarachnoid hemorrhage

A
  • coiling with cathether
  • clipping (surgery)
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27
Q

cognitive consequences of a stroke: medial cerebral artery

A

memory
language
motor disorders (parese, ataxia, apraxia)

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28
Q

consequences of stroke: frontal lobe

A

exectutive orders

(bv anterior communicating artery)

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29
Q

wanneer neuropsychological assessment

A

subacute phase & after 6 months

30
Q

left hemisphere stroke problems

A

aphasia (comprension + communication -> reading, speaking, writing)
apraxia (inability to carry out meaningful movements and gestures)
depression

31
Q

neglext =

A

not aware of stimuli on the contra lesional side

32
Q

bij welke hemisphere vaak neglect

A

bij right hemisphere (dus linkerkant niet zien)

33
Q

cognitive consequences of stroke

A
  • Attention and speed of information processing
  • Memory
  • Language (aphasia)
  • Perception
  • Executive functions
  • Praxis and motor systems
  • Social cognition
  • Reduced self awareness
  • Anosognosi
34
Q

emotional and behavioural consequences

A
  • Fatigue
  • Emotional / lability
  • Depressive / anxiety
  • Irritability /aggressive
  • Sexual problems
  • Underestimating / overestimating self
  • Impulsive
  • Reduced initiative
35
Q

post stroke emotional problems in left hemisphere

A

depression or catastrophic reaction

36
Q

post stroke emotional problems in right hemisphere

A

indifferent, euphoric reactions, reduced self-awareness

37
Q

frontal stroke emotional problems

A

impulsive, disinhibited.

38
Q

wat waren de bovengenoemde post stroke emotional problems?

A

direct effects of the lesion!

direct gaat om location of the stroke

39
Q

post stroke emotional problems: indirect effects of lesions

A

significant relationship between size, not location of the lesion.

dus indirect gaat om size of the stroke

40
Q

indirect lesion associations with..

A

dus size
association with cognitive impairments

41
Q

hoeveel mensen diagnosed with traumatic brain injury each year in NL

A

85.000

42
Q

hoeveel mensen met TBI sterven uiteindelijk

A

4-6%

43
Q

prevalence in NL chronic tbi patients

A

200.000

44
Q

hoeveel mensen discharged home met tbi

A

90%, often with little rehabilitation

45
Q

majority of tbi patients is…

A

15-24 years old

46
Q

gender in tbi

A

men 2x zovaak als women

47
Q

2 types of tbi

A

open skull fracture tbi
closed tbi

48
Q

open skull fracture tbi voorbeelden

A

penetrating objects
bullet wounds

49
Q

closed tbi voorbeelden

A

traffic accidents
fall from height
blows to the head
violence
industrial accidents

50
Q

open skull fracture tbi kenmerken

A

local lesiono
rotating forcees: diffuse neural damage
risk of secondary microbleeds

51
Q

closed tbi kenmerken

A

focal atrophy (coup-contrecoup)
rotating forces (neuronal shearing)
microbleeds

52
Q

focal atrophy: 2 vormen

A

frontal impact = frontal + occipital
sideways impact = temporal lobes

53
Q

delayed effect in adults =

A

boxers syndrome
chronic traumatic encephalopathy

54
Q

hoe zie je delayed effect

A

rapid development of dementia and/or Parkinson-like deficits a few years after series of head trauma’s

55
Q

secondary damage of tbi

A

subarachnoid haemmorhages:

Traumatic subarachnoid hemorrhage occurs regularly following moderate and severe TBI and is associated with poorer and slower
recover

56
Q

classification of traumatic brain injury: duration of unconsciousness

A

mild = < 30
moderate = 30 min - 24 hours
severe > 24 hours

57
Q

classification tbi: post traumatic amnesia

A

mild = < 24 hours
moderate = 1-7 days
severe = > 7 days

58
Q

prognosis depends on …

A

severity

59
Q

glasgow coma schale is gebaseerd op 3 dingen

A

opening the eyes
motor reaction
verbal response

60
Q

prevalences mild vs moderate vs severe tbi

A

mild = 80-85%
moderate = 10%
severe = 5-10%

61
Q

is iq a good measure to assess cognitive deficits after tbi

A

NO!!

62
Q

mental abilites affected by tbi are..

A
  • Speed of information processing
  • Attention
  • Executive functions
  • Memory
  • Language and speech
  • Social cognition

TBI = SALEMS

(STROKE = PALMPEAS)

63
Q

verschillende tijdsduur van post traumatic amnesia en unconsciousness

A

unconsciousness = < 30, 30-24, 24

post traumatic amnesia = 24, 7 days more than 7 days

64
Q

but… what could explain what symptoms?

A

attention problems could be explained by speed of processing

dus speed of processing -> attention

65
Q

dysexecutive syndrome = problems with…

A
  • planning
  • flexibility
  • inhibition of the dominant response
  • monitoring, use of feedback
  • insight
66
Q

memory 4 types

A
  1. remote memory (retrograde maar dan alleen de day before)
  2. retrograde amnesia
  3. post-traumatic amnesia
  4. anterograde amnesia
67
Q

welke is het vaakste aangedaan bij tbi

A

anterograde amnesia

68
Q

hoe meet je anterograde amnesia

A

rey auditory verbal learning test

69
Q

social cognition problems

A
  • Difficulty to perceive emotional stimuli
  • Problems with understanding emotions and
    thoughts of others
  • Difficulty seeing things from another perspective
  • Difficulty inhibiting behavior
70
Q

emotional and behavioural consequences

A
  • Emotional lability
  • Irritability (aggressiveness)
  • Apathy
  • Loss of initiative
  • Disinhibited (loss of decorum)
  • Egoistical behaviour
71
Q

wie heeft het meeste last van emotional + behavioural consequences

A

not the patient but the family/partner

Clinical & Neuropsychology (29 decks)

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