Stroke Flashcards
Most common sites for lesion to occur from CVA
Origin of common carotid artery
Main bifurcation of the middle cerebral artery
Jxn of vertebral arteries w/ basilar artery
Middle Cerebelar Artery Stroke
- CONTRA hemiplegia
- Mostly UE involvement
- Loss of sensation primarily in arm/face
- Homonymous hemianopsia is common
- Infarct in a dominant left hemisphere = apraxia and aphasia
- Occulusion of main stem can cause global aphasia <!--EndFragment-->
- *hemisphere lesion: cortex and internal capsule
Anterior Cerebral (rare)
- Contralateral hemiplegia and sensory loss
- more involved LE than UE
- Can result in mental confusion (akinetic mutism), aphasia, and apraxia
- contralateral neglect if involvement is extensive on the dominant side
- Hemisphere lesion: cortex and internal capsule
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Posterior Cerebral
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- Contralateral sensory loss
- **Involuntary movements - choreoathetosis, tremor etc **
- **Persistent pain syndrome (webers) **
- visual agnosia
- dyslexia
- occulomotor nerve palsy
- Temporary sensory loss
- Homonymous hemianopsia
- Thalamic pain syndrome
- Hemisphere lesion: Primary Visual cortex, occipital lobe
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Vertebral-Basilar Stroke
- Often results in death from edema associated
- if patient survives, and the lesion affected the Pons, the result could be quadriparesis and bulbar palsy (locked in syndrome)
- Other symptoms include:
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- Vertigo
- Coma
- Diplopia
- Nausea
- Dysphagia
- Ataxia
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Anterior Inferior Cerebellar Stroke
- Unilateral deafness
- Loss of pain and temp on Contralateral side
- Paresis of lateral gaze
- Unilateral Horner’s syndrome
- Ataxia
- Vertigo
- nystagmus
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Superior Cerebellar Stroke
- Severe ataxia
- Dysarthria
- Dysmetria
- Contralateral loss of pain and temperature
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Posterior Infererior Cerebellar
Wallenberg’s syndrome:
- Vertigo
- Nausea
- Hoarseness
- Dysphagia
- Ptosis
- Decreased impairment of sensation in ipsilateral face and contralateral torso/limns
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Lacunar (Pure Motor) Infarct
- Lesion: internal capsule - posterior limb
- contralateral hemiplegia UE and LE
- NO APHASIA
- Visueal Field deficit
Midbrain Lesion
- contralateral hemiplegia
- contralateral CN III palsy
Stages of Recovery Following Stroke
Stage 1: Flaccid, no limb movement
Stage 2: synergies may appear. Spasticity begins to develop. Minimal voluntary movement
Stage 3: spasticity increases and may become severe. Voluntary control of movement synergies appears
Stage 4: Some movement independent of the synergies. Spasticity begins to decline
Stage 5: If patient progresses, synergies no longer dominate and movement becomes more complex
Stage 6: Spasticity is gone. Coordination and movement approach normal
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Right Sided Stroke (Left Hemiplegia)
- Problems w/ spatial relationships and hand-eye coordination
- Irritability, short attention span
- Cannot rettain information, difficulty learning individual steps.
- Poor judgement affecting personal safety
- Diminished body image with left-sided neglect
- Quick and impulsive
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Left Sided Stroke (Right Hemiplegia)
- Apraxia
- Difficulty starting and sequencing tasks
- Perseveration
- Easily frustrated with high levels of anxiety
- Inability to communicate verbally
- Cautious and slow
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Risk Factors for Stroke
Primary and Secondary
Hemisphere Specialization: Left Brain
- language
- sequence and perform mvmnts
- understand language
- produce written and spoken language
- analytical
- controlled
- logical
- rational
- mathematical calculations
- express positive emotions such as love and happiness
- process, verbally coded information in an organized, logical and sequential manner
