Stroke and Vascular Dementia

Question 1

What causes strokes?

Answer 1

BLOCKAGE in the brain!

Question 2

What is a Transient Ischemic Attack (TIA)?

Answer 2

aka “mini-stroke
- a stroke that only lasts a few minutes
- blood supply to brain is briefly blocked
- symptoms same as stroke just not as long

Question 3

What does F.A.S.T stand for for stroke survival?

Answer 3

Face –> one side drooping?
Arms –> cannot put one arm up?
Speech –> slurred or strange with simple phrase?
Time–> CALL 911!!

Question 4

What are the 8 common effects of a stroke?

Answer 4

1. weakness or paralysis in legs/arms *unilateral
2. shoulder pain *unilateral
3. dysphagia (trouble swallowing)**
4. sensory/perceptual probs
5. aphasia (probs with language)
6. incontinence (loss of bowels)
7. difficulties with emotion control
8. fatigue

Question 5

What consists of a right hemisphere stroke?

Answer 5

• left side weakness or paralysis
• spatial probs
• unilateral neglect
• anosognosia
• apraxia

Question 6

What is unilateral neglect in right hem. stroke?

Answer 6

where a person ignores things in their left visual field
ex: goes to copy a picture of a cat and only draws the stuff in their right visual field and not their left (looks like half a cat)

Question 7

What is anosgnosia ?

Answer 7

inability to acknowledge the physical reality of a stroke

Question 8

What is apraxia?

Answer 8

Difficulty planning and executing complex motor sequences
all about MOVEMENT

Question 9

What consists of Left hemisphere strokes?

Answer 9

• 3 types of aphasia (non-fluent , fluent, global)
• probs with short term memory
• has trouble learning new info
• anosognosia (not as common)
• apraxia

Question 10

What is Non-Fluent Aphasia/Broca’s Aphasia in LH strokes?

Answer 10

aka “Broca’s aphasia”
- impaired language production –> syntax (grammar) mostly
- can comprehend language well
- aware of deficit

Question 11

What is Fluent/Werknicke’s Aphasia in LH strokes?

Answer 11

can produce language but what they are saying does NOT make sense and they use made-up words

cannot comprehend language

not aware of this deficit

Question 12

What are brain stem strokes?

Answer 12

affects breathing –> impairs speech
problems with organzing and percieving environment
balance problems
dizzy (vertigo)
sleeping probs (insomnia, sleep apnea)

Question 13

What are cerebellar strokes?

Answer 13

cause abnormal head/torso relfexes

coordination and balance problems

Question 14

look at slide 14-15 for different therapy options

Question 15

What is Vascular dementia?

Answer 15

caused by reduced blood flow to the brain –> kills brains cells
impacts everyday life severely

Question 16

What are 3 reasons there may be reduced blood flow to brain for vascular dementia?

Answer 16

1. narrowing of small blood vessels deep in brain (subcortical vascular dementia)
2. stroke (single-infarct dementia)
3. many mini strokes –> caused widespread damage (multi-infarct dementia)

Question 17

What are the risk factors to vascular dementia (x7)?

Answer 17

-age
-smoker
-atherosclerosis
- high BP
- diabetes
- high cholesterol

Question 18

What are some common symptoms of vascular dementia?

Answer 18

1. confusion/agitation
2. problems with memory, attention, concentration
3. unsteady gait
4. incontinence
5. night wandering
6. depression
7. cant organize thoughts
8. cant plan ahead and speak sequentially

Question 19

Is it hard classifying cognitive states relevant to stroke?

Answer 19

• yes because there is so much overlap!

Question 20

How do we treat vascular dementia (hint:just like AD)?

Answer 20

• cholinesterase inhibitors (“aricept”) –> boost acetylcholine which is good for memory
• Memantine/Namenda –> regulates glutamate
  just like AD!