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Clinical Neuropsychology > PSYC 492 UNIT 3 - Cerebrovascular Disease > Flashcards

PSYC 492 UNIT 3 - Cerebrovascular Disease Flashcards

1
Q

What is cerebrovascular disease?

A

blockage in blood supply or bleeding in the brain

3.28.24 ADHDpart2 and Cerebrovascular Disease

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2
Q

What kind of damage can cerebrovascular disease and associated impairment of blood supply cause?

A
  1. decreases oxygenation
  2. bleeding may lead to increased intracranial pressure
  3. toxins in blood might interfere with brain metabolism
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3
Q

List 5 examples of cerebrovascular disease.

A
  • stroke
  • carotid stenosis
  • vertebral and intracranial stenosis
  • aneurysms
  • vascular malformations
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4
Q

What is a stroke?

A

injury to the brain caused by blockage or bleeding

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5
Q

Typically, strokes are ———— but multiple strokes or major stroke can ———–.

A

localized; affect the entire brain

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6
Q

The ———- of a stroke reflects damage.

A

clinical presentation

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7
Q

What are the common warning signs of stroke?

A

B - Balance (stumbling, coordination is awry)
E - Eyes (vision changes)
F - Face (facial droop)
A - Arms (weakness in arms)
S - Speech (slurred)
T - Time (call 911 ASAP!)

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8
Q

Why is the “time” in BEFAST so important?

A

if a person is having a stroke, the longer they go without treatment, the more damage that happens

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9
Q

What are some differences in stroke symptoms for women?

A

Women may experience additional symptoms like:
- general weakness
- disorientation/confusion/memory
- fatigue
- nausea or vomiting

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10
Q

How many people in the US have a stroke per year? How many of these are new cases? How many people have had a previous stroke?

A

over 795000
new: 619000
have had previous stroke: 1/4

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11
Q

Every —- , someone has a stroke.

Every ——-, someone dies of a stroke.

In our 75min class, how many people will have died from stroke?

A
  • 40 seconds
  • 3.5 minutes
  • 21 people
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12
Q

Stroke is the —– leading cause of death in the US.

A

3rd

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13
Q

T/F

Stroke only occurs in older people.

A

False, strokes can occur at any age. 38% are less than 65yo

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14
Q

Who is at greatest risk for having a stroke (ethnicity and gender)?

A

Black Americans are 2x more likely to have a stroke thank White Americans.

Black Americans have the highest rate of death due to stroke.

Stroke is more common in men than women.

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15
Q

What physical health factors put people at a higher risk for stroke?

6

A
  • high blood pressure
  • high cholesterol
  • smoking
  • obesity/physical inactivity
  • diabetes
  • prior heart attack/stroke
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16
Q

While genetics play into the physical health risk factors for stroke, we also need to consider how ——————/—————— affect physical health.

A

socioeconomic/social determinants

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17
Q

What are the two primary types of stroke?

A

Hemorrhagic and ischemic

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18
Q

What are the 3 types of ischemic stroke?

A
  • thrombotic
  • embolic
  • transient ischemic attack (TIA)
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19
Q

What is an ischemic stroke?

A

the death of neural tissue due to inadequate blood supply (obstruction of blood circulation)

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20
Q

T/F

Hemorrhagic strokes account for the majority of strokes.

A

False, ischemic strokes are more common

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21
Q

Thrombosis often affects which artery?

A

left middle cerebral artery, but arteries of all sizes are affected

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22
Q

A(n) ———- stroke is more likely to affect anterior areas.

A

embolic stroke

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23
Q

What is the main difference between a thrombotic stroke and embolic stroke?

A

thrombotic stroke: buildup (thrombosis) that obstructs blood circulation and blocks off the ability for red blood cells to flow freely through blood vessels

embolic stroke: an embolus breaks off from buildup in a blood vessel, then floats through the blood stream, blocking blood flow in a different place in the body

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24
Q

A Transient Ischemic Attack (TIA) is a(n) ——–, ———- neurological deficit, ———– loss of function (order of minutes) from ——– blockage of blood flow to the brain.

A

A Transient Ischemic Attack (TIA) is a(n) -acute, focal neurological deficit causing transient loss of function (order of minutes) from temporary blockage of blood flow to the brain.

25
Q

How often do TIA’s occur?

A

varies - can occur infrequently to very frequently (several times/day)

26
Q

In a TIA, if anterior circulation is blocked, it causes the following symptoms:

3

A
  • clumsiness/weakness of limbs
  • dysarthria (unclear speech)
  • aphasia (impairment to expression/understanding of language)
27
Q

In a TIA, if posterior circulation is blocked, it can cause the following:

4

A
  • dizziness
  • neglect
  • double vision
  • numbness/weakness in extremities
28
Q

People who have had a TIA are at a —- to —-% greater risk of a more serious stroke.

A

20% - 35%

29
Q

What is a hemorrhagic stroke?

A

rupture of blood vessel causes spilling of blood into cerebral tissue

30
Q

An accumulation of blood within tissue is called ————-

A

a hematoma

31
Q

a bleed within the brain is called a(n) —————–

A

intracerebral hemorrhage

32
Q

When a vessel on the brain’s surface bursts and bleeds into the subarachnoid space, it is called a(n) ———————–

A

subarachnoid hemorrhage

33
Q

What are three ways a subarachnoid hemorrhage might present?

A
  • sudden, severe generalized headache/vomiting
  • sudden, severe generalized headache with loss of consciousness
  • rapid loss of consciousness with no other complaints
34
Q

How might an intracerebral hemmorhage present?

A

generally focal, neurological deficits but also may experience headache, vomiting, and altered consciousness with expansion

35
Q

A stroke’s impact on neuropsychological outcomes is dependent on what factors?

5

A
  • size
  • location
  • duration of occlusion
  • time since stroke
  • age
36
Q

What does the timeline for recovery from a stroke typically look like?

A

Patients experience majority of recovery in first 3-6 months; additional but less pronounced recovery in 6-12 months.

37
Q

T/F

Strokes are only caused by genetic factors.

A

False

38
Q

T/F

The majority of recovery after stroke occurs after 12 months.

A

False

39
Q

Ischemic strokes can arise from thrombotic or embolic events.

A

True

40
Q

The —————- in which the stroke occurs can have a significant affect on symptomology.

A

cerebral artery

41
Q

In which arteries do strokes commonly occur?

3

A
  • middle cerebral artery stroke
  • anterior cerebral artery stroke
  • posterior cerebral artery
42
Q

What would a middle cerebral artery stroke look like? (also describe left v. right)

A
  • contralateral motor and sensory deficits
  • dorsolateral executive dysfunction
  • visuoconstructional deficits

Left:
- aphasia
- ideomotor apraxia (difficulty pantomiming but intact knowledge)
- verbal memory

Right:
- aprosodia (receptive-inferior; expressive-superior)
- dressing apraxia (inability to dress self)
- visual memory

LOOK UP what symptoms mean

aprosodia - impaired comprehension of verbal/nonverbal speech

43
Q

What would an Anterior Cerebral Artery stroke look like?

A
  • contralateral weakness
  • sensory deficit affecting legs
  • motor impersistence (inability to sustain certain actions)
  • abulia/apathy (abulia = no willpower)
  • complex/divided attention
  • memory deficits

Left:
- Executive Function including verbal reasoning, transcortical motor aphasia (non-fluent; stop/start speech), verbal fluency

Right:
- Executive function including poor social insight and judgement

44
Q

What would a stroke in the Posterior Cerebral Artery look like?

A
  • contralateral homonymous hemianopia (vision lost in opposite halves of each eye)
  • contralateral hemisensory affecting hands
  • constructional apraxia (inability to copy drawings)
  • visuoperceptual deficits
  • color anomia (inability to find the name, but knows color)
  • memory loss with poor encoding

Left:
- verbal memory loss
- transcortical sensory aphasia (impaired auditory comprehension with intact repitition and fluent speech)
- visuoconstructional – loss of detail but gestalt maintained

Right:
- visual memory loss
- agnosias (cannot recognize object)
- visuoconstructional (detailed but loss of gestalt), hemi-neglect

45
Q

What mood/affect and personality changes might a person with a stroke on the left side have?

A
  • “catastrophic reaction”
  • depression and affective lability (strong, variable emotions)
  • often tearful and might have pseudobulbar affect

4.2.24 Stroke Part 2

46
Q

What is pseudobulbar affect?

A

uncontrolled crying or laughing that is disproportionate/inappropriate for the social context

47
Q

What do we mean by a “catastrophic reaction” and what disorder might cause it?

A

disruptive, emotional outburst involving anxiety, agitation, aggression
- occurs after stroke on left side (left-sided lesion to brain)

48
Q

What mood/affect and personality changes might be experienced by a person with a right-sided lesion (stroke on right side)?

A
  • affective flattening and indifference
  • difficulty with nonverbal cues in social settings
  • pronounced behavioral changes
  • amotivation, abulia, apathy, agitation
  • decreased inhibition, lack of regard

abulia = absence of willpower/decision making issues

49
Q

a bulge in a blood vessel caused by weakness in the vessel wall

A

aneurism

50
Q

What are three types of aneurysms?

A
  • saccular (berry) aneurism
  • fusiform aneurysm
  • dissecting aneurysm
51
Q

aneurysm resulting in congenital weakness

A

saccular aneurysm

52
Q

aneurysm associated with enlargement of vessels from atherosclerosis

A

fusiform aneurysm

53
Q

aneurysm characterised by a tear in the vessel wall that allows blood to seep through the laters of the blood vessel

A

dissecting aneurysm

54
Q

Which type of aneurysm may lead to an ischemic stroke?

A

fusiform aneurysm

55
Q

Congenital collections of abnormal vessels resulting in abnormal blood flow.

A

Arteriovenous Malformation (AVM)

56
Q

AVM is typically seen in —— patients with ——– hemorrhage. This typically ends in ————– survival.

A
  • younger
  • smaller
  • better
57
Q

When an individual has an AVM, what symptoms do they typically experience beforehand?

A
  • typically no symptoms until hemorrhage
  • some may experience headache and/or seizure
58
Q
A

Clinical Neuropsychology (14 decks)

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