Stroke Flashcards

Question

what is important to note with a TIA?

Answer 1

can be a warning that you may have a stroke and an opportunity to prevent this from happening

Answer 2

ischemic stroke that occurs in the MCA - can involve the frontal, temporal and parietal lobes

Answer 3

deficits in movement and sensation of the legs, arms & lower 2/3 of the face difficulty swallowing (dysphagia) impaired speech ability with left MCA impaired vision and partial contralateral blindness headaches hemineglect (right MCA) UL more affected than LL impulsiveness

Answer 4

* Right hemiparesis - Variable involvement of face and upper and lower extremity * Right-sided sensory loss in a pattern similar to that of the motor deficit - Usually involves all modalities, decreased stereognosis, and agraphesthesia, left-right confusion * Right homonymous hemianopia * Dysarthria * Aphasia, fluent and nonfluent * Alexia, Agraphia, Acalculia, Apraxia

Answer 5

* Left hemiparesis - Same pattern as on right * Left-sided sensory loss - Similar pattern that of the motor deficit * Left homonymous hemianopia - Same pattern as on right * Dysarthria * Neglect of the left side of environment * Anosognosia * Asomatognosia * Loss of prosody of speech * Flat affect

Answer 6

involvement of the occipital lobe, the medial lobe, the medial temporal lobe or the thalamus

Answer 7

contralateral homonymous hemianopia cortical blindeness (bilateral lesions)

Answer 8

*Deficits in long-term and short-term memory *Behaviour alteration (agitation, anger, paranoia)

Answer 9

–Contralateral sensory loss –Aphasia (if dominant side involvement) –Executive dysfunction –Decreased level of consciousness –Memory impairment

Answer 10

–Crossed sensory findings (e.g. ipsilateral face and contralateral body numbness) –Crossed motor findings (ipsilateral face, contralateral body) –Gaze-evoked nystagmus –Ataxia and vertigo, limb dysmetria –Diplopia and eye movement abnormalities –Dysarthria, dysphagia –Tongue deviation –Deafness (very rare) –Locked-in syndrome (can’t move any limb, can’t speak, can sometimes blink)

Answer 11

* Ipsilateral 3rd nerve palsy * Contralateral hemiparesis of the arm and leg, sometimes with hemiplegia of the face * Contralateral hemiataxia

Answer 12

*Ipsilateral signs: *Horner’s syndrome *6th or 7th nerve palsy (diplopia, whole side of face is weak) *Hearing loss (rare) *Loss of pain and temperature sense *Contralateral signs: *Weakness in leg and arm *Loss of sensation in arm and leg *Nystagmus, nausea

Answer 13

*Ipsilateral signs: *Tongue weakness *Sensory loss in face *Horner’s syndrome *Ataxia *Palate weakness (dysphagia) *Contralateral signs: *Weakness, sensory loss in arm and leg *Nausea, nystagmus, dysphagia, dysarthria

Answer 14

*Ischemia involving: *Superior cerebellar artery (SCA) *Anterior or posterior inferior cerebellar artery (AICA or PICA) *Ataxia, vertigo, nausea, vomiting, dysarthria *Often headache and nystagmus *Can also have rapid deterioration in level of consciousness

Answer 15

*Infarction causes edema resulting in mass effect, herniation and compression of the fourth ventricle *This can lead to rapid deterioration in level of consciousness *Surgical decompression is often necessary in these circumstances

Answer 16

DANISH Dysdiadochokinesia: the lack of ability to perform rapidly alternating movements. Ask the patient to quickly supinate and pronate both forearms simultaneously. Movements will be slow and incomplete on the side of the cerebellar lesion. Ataxia: voluntary movement disturbance involves tremor with fine movements eg writing or buttoning the clothes. UL: Finger to nose test- testing tip of the nose with the index finger test the movements are not properly coordinated. LL: ask patient to place the heel of one foot against the shin of the opposite leg. Nystagmus: Ataxia of ocular muscles, a rhythmical oscillation of the eyes. To provoke nystagmus, the patient should rotate eyes horizontally Intention tremor Dysarthria/Scanning speech: ataxia of the larynx muscles, speech is slurred and syllables are separated from one another. Hypotonia: the muscles lose resistance to palpation. The patient walks with a broad-based gait and leans toward the affected side. Rebound phenomenon- Rebound phenomenon is a reflex that occurs when a patient attempts to move a limb against resistance that has been suddenly removed Pendular knee jerk- the leg continues to move several times after the initial reflex

Answer 17

occlusion of the penetrating branches of the circle of Wills, middle cerebral stem, and vertebral and basilar arteries, affecting the deep grey and white matter of the cerebrum and brainstem

Answer 18

Pure motor stroke usually arises from infarction in the posterior limb of the internal capsule; course is often stuttering over hours to days. Pure sensory stroke usually arises from thalamic infarction

Answer 19

weakness and sensory loss with no visual field deficit, aphasia, neglect, ataxic hemiparesis (often arises in the corona radiata), clumsy hand-dysarthria (caused by infarction in the pons)

Answer 20

 Deep location: usually due to rupture of small, deep perforating artery; often associated with hypertension.  Superficial/lobar location: cerebral amyloid angiopathy often the cause; older patients.  Other common causes: arteriovenous malformation/cavernoma; ruptured saccular aneurysm; coagulopathy

Answer 21

thunderclap headache eg “worst headache of my life.” A headache often is associated with nausea, vomiting, and diplopia. Often signs of meningismus, neck stiffness Cranial nerve deficits Often in a state of coma and unconscious

Answer 22

Basilar artery thrombosis and bilateral infarction of the ventral pons

Answer 23

Sudden onset Patients develop acute hemiparesis rapidly progressing to quadriplegia and lower bulbar paralysis. Initially the patient is dysarthric and dysphonic but rapidly progresses to mutism (anarthria). Consciousness and sensation is preserved. The patient cannot move or speak but remains alert and oriented. Mortality rates are high (59%), and survivors are left with severe impairments associated with brainstem injury

Answer 24

deficit in comprehension and severe difficulty in reading and writing. Lesions causing this problem are usually in the dominant temporal lobe.

Answer 25

comprehension is usually preserved but language expression is affected. Lesions are usually in the dominant frontal lobe. Broca’s aphasia, also called ‘expressive’ or ‘non-fluent aphasia’, may result in almost complete loss of language expression to a slowed, deliberate speech utilizing only key words and simple grammatical structure.

Answer 26

the problem of understanding language, fluent

Answer 27

the problem of producing the correct word or sequence of words, non-fluent.

Answer 28

damage to the regions of the left cerebral cortex

Answer 29

difficulty swallowing can lead to aspiration of saliva, food or liquids

Answer 30

when you accidentally inhale food, liquid or other material into your trachea (windpipe or airway) and you don't know it.

Answer 31

patients actively push away from the nonhemiparetic side, leading to a loss of postural balance The perception of body posture in relation to gravity is altered. The patients experience their body as oriented “upright” when the body actually is tilted to the side of the brain lesion (to the ipsilesional side).