Strokes/aprosodias/apraxia/aphasias Flashcards
Motor Aproodias
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia
Inability to execute facial movements on command
Sensory Aprosodias
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia
Inability to execute facial movements on command
Brocas Aphasia
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia
Inability to execute facial movements on command
Wernicke’s Aphasia
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia
Inability to execute facial movements on command
Global Aphasia
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia
Inability to execute facial movements on command
Ideational Apraxia
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia (apraxia – unable to perform particular purposeful actions)
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to execute facial movements on command
Ideomotor Apraxia
Ideomotor Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Posterior Parietal Cortex
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia (apraxia – unable to perform particular purposeful actions)
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to execute facial movements on command
Kinetic Apraxia
Kinetic Apraxia (apraxia – unable to perform particular purposeful actions)
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
posterior parietal cortex
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia (apraxia – unable to perform particular purposeful actions)
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to execute facial movements on command
Oral Apraxia
Oral Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to execute facial movements on command
posterior parietal cortex
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia (apraxia – unable to perform particular purposeful actions)
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to execute facial movements on command
Aprosodias
Aphasias
Apraxias
Name
Features/Causes
Area of Damage
Motor Aprosodias
Unable to CONVEY feelings by voice or gesture, but feelings are there. Becomes very monotone
Right frontal cerebral hemisphere
Sensory Aprosodias
Unable to READ feelings. Trouble comprehending content of speech
Most posterior region of Right cerebral Hemisphere
Broca’s Aphasia
Also known as motor aphasia
Fluency: low
Repetition: low
Comprehension: high
Damage to left frontal lobe )post. Inf. Frontal gyrus)
Common with stroke to MCA
Wernicke’s Aphasia
Also known as sensory aphasia
Fluency: high
Repetition: low
Comprehension: low
Will often see made up words
Damage to superior temporal gyrus
Global Aphasia
Impairment in language, production and comprehension
Damge destroying nearly all of perisylivan area
Ideational Apraxia (apraxia – unable to perform particular purposeful actions)
Inability ot organize single actions into a sequence for intended purposes
Ask them to brush their hair, and they cant.
FUNCTIONALLY AND CLINICALLY
Posterior parietal cortex
Ideomotor Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to translate idea for their actions into appropriate motor program
Ask them to brush their hair, and they cant. But turn around and have no problem seeing a brush and brushing hair
FUNCITONALLY
Kinetic Apraxia (apraxia – unable to perform particular purposeful actions)
Loss of hand and finger dexterity, not due to paresis, ataxia (uncoordinated movement), or sensory loss
Oral Apraxia (apraxia – unable to perform particular purposeful actions)
Inability to execute facial movements on command
Strokes
MCA
MCA (middle cerebral artery)
Internal capsule, thalamus, basal ganglia
Cerebral cortex
Most common site for strokes
Ischemic strokes
Cortical branches: contralateral sensory loss and weakness of UMN type, cognitive problems, and contralateral homonymous hemianopsia.
More distal stem damage: UE and face symptoms more than LE
When dominant (left mostly) hemisphere affected – aphasia may occur
When non-dominant (right mostly) hemisphere affected, problems with prosody or unilateral visuospatial deficits may occur. also neglect
PCA
Med. And inf. Temporal/occipital lobes, midbrain thalamus
Cerebral cortex
*Ischemic stroke
BILATERAL Occlusion occurs with Single embolic or thormbolic occlusion of upper basilar artery
UNILATERAL Occlusion leads to contralateral homomunous hemianopsia (may present with macular sparing)
- When dominant (mostly left) hemisphere damage:
- alexia (inability to see words or to read),
- anomia (a form of aphasia in which a patient is unable to recall the names of everyday objects),
- visual agnosia (cannot recognize or interpret visual information – man who mistook his wife for a hat)
BILATERAL PCA Infarction
occurs with: single embolic or thrombotic occlusion of basilar artery
Results in:
- bilateral homomynous hemianopsia (cortical blindness)
- inferomedial temporal lobes infarcted: severe memory problems
- prosopagnosia (cannot recognize faces – mary jane)
*NO MOTOR/SENSORY LOSS
ACA
territory: Ant. med. Cerebral hemisphere, ant. corpus callosum, caudate nucleus, internal capsule
supplies: Cerebral cortex
Part of the circle of Willis (more variability in symptoms)
Less common than MCA
Ischemic Stroke
Mainly embolic, rarely due to atherosclerosis
Note: A thrombus is formed after a blood vessel is broken, and platelets help it clot! When a piece of a thrombus breaks off and travels to a different part of the body, it is called an embolus. An embolus is a blockage cuasing piece of material inside a blood vessel (can be a thrombus, fat globule, gas, or foreign material).
Athersosclerosis: hardening of the artery wall due to plaque.
symptoms and damage
STEM: damage at stem may not cause any damage due to connection with anterior communicating collateral
CORTICAL BRANCHES: Involvement of cortical branches of one ACA causes UMN weakness & cortical type sensory defiticits mostly CONTRAlateral LE and bowel and bladder dysfunction.
BILATERAL ACA INFARCTION:
Due to anomaly of circle of Willis.
Resultant cortical sensory-motor syndrome involving both LE
Severe behavioral disturbance with wide oscillations of affect and personality
May also cause apraxia (inability to perform particular purposeful action)
Stroke ACA
ACA
territory: Ant. med. Cerebral hemisphere, ant. corpus callosum, caudate nucleus, internal capsule
supplies: Cerebral cortex
Part of the circle of Willis (more variability in symptoms)c
Less common than MCA
Ischemic Stroke
Mainly embolic, rarely due to atherosclerosis
Note: A thrombus is formed after a blood vessel is broken, and platelets help it clot! When a piece of a thrombus breaks off and travels to a different part of the body, it is called an embolus. An embolus is a blockage cuasing piece of material inside a blood vessel (can be a thrombus, fat globule, gas, or foreign material).
Athersosclerosis: hardening of the artery wall due to plaque.
symptoms and damage
STEM: damage at stem may not cause any damage due to connection with anterior communicating collateral
CORTICAL BRANCHES: Involvement of cortical branches of one ACA causes UMN weakness & cortical type sensory defiticits mostly CONTRAlateral LE and bowel and bladder dysfunction.
BILATERAL ACA INFARCTION:
Due to anomaly of circle of Willis.
Resultant cortical sensory-motor syndrome involving both LE
Severe behavioral disturbance with wide oscillations of affect and personality
May also cause apraxia (inability to perform particular purposeful action)
MCA (middle cerebral artery)
Internal capsule, thalamus, basal ganglia
Cerebral cortex
Most common site for strokes
Ischemic strokes
Cortical branches: contralateral sensory loss and weakness of UMN type, cognitive problems, and contralateral homonymous hemianopsia.
More distal stem damage: UE and face symptoms more than LE
When dominant (left mostly) hemisphere affected – aphasia may occur
When non-dominant (right mostly) hemisphere affected, problems with prosody or unilateral visuospatial deficits may occur. also neglect
PCA
Med. And inf. Temporal/occipital lobes, midbrain thalamus
Cerebral cortex
*Ischemic stroke
BILATERAL Occlusion occurs with Single embolic or thormbolic occlusion of upper basilar artery
UNILATERAL Occlusion leads to contralateral homomunous hemianopsia (may present with macular sparing)
When dominant (mostly left) hemisphere damage:
alexia (inability to see words or to read),
anomia (a form of aphasia in which a patient is unable to recall the names of everyday objects),
visual agnosia (cannot recognize or interpret visual information – man who mistook his wife for a hat)
BILATERAL PCA Infarction
occurs with: single embolic or thrombotic occlusion of basilar artery
Results in:
bilateral homomynous hemianopsia (cortical blindness)
inferomedial temporal lobes infarcted: severe memory problems
prosopagnosia (cannot recognize faces – mary jane)
*NO MOTOR/SENSORY LOSS
PCA Stroke
PCA
Territory:
Med. And inf. Temporal/occipital lobes, midbrain thalamus
supplies:Cerebral cortex
*Ischemic stroke
BILATERAL Occlusion occurs with Single embolic or thormbolic occlusion of upper basilar artery
UNILATERAL Occlusion leads to contralateral homomunous hemianopsia (may present with macular sparing)
When dominant (mostly left) hemisphere damage:
alexia (inability to see words or to read),
anomia (a form of aphasia in which a patient is unable to recall the names of everyday objects),
visual agnosia (cannot recognize or interpret visual information – man who mistook his wife for a hat)
BILATERAL PCA Infarction
occurs with: single embolic or thrombotic occlusion of basilar artery
Results in:
bilateral homomynous hemianopsia (cortical blindness)
inferomedial temporal lobes infarcted: severe memory problems
prosopagnosia (cannot recognize faces – mary jane)
*NO MOTOR/SENSORY LOSS
ACA
territory: Ant. med. Cerebral hemisphere, ant. corpus callosum, caudate nucleus, internal capsule
supplies: Cerebral cortex
Part of the circle of Willis (more variability in symptoms)c
Less common than MCA
Ischemic Stroke
Mainly embolic, rarely due to atherosclerosis
Note: A thrombus is formed after a blood vessel is broken, and platelets help it clot! When a piece of a thrombus breaks off and travels to a different part of the body, it is called an embolus. An embolus is a blockage cuasing piece of material inside a blood vessel (can be a thrombus, fat globule, gas, or foreign material).
Athersosclerosis: hardening of the artery wall due to plaque.
symptoms and damage
STEM: damage at stem may not cause any damage due to connection with anterior communicating collateral
CORTICAL BRANCHES: Involvement of cortical branches of one ACA causes UMN weakness & cortical type sensory defiticits mostly CONTRAlateral LE and bowel and bladder dysfunction.
BILATERAL ACA INFARCTION:
Due to anomaly of circle of Willis.
Resultant cortical sensory-motor syndrome involving both LE
Severe behavioral disturbance with wide oscillations of affect and personality
May also cause apraxia (inability to perform particular purposeful action)
MCA (middle cerebral artery)
Internal capsule, thalamus, basal ganglia
Cerebral cortex
Most common site for strokes
Ischemic strokes
Cortical branches: contralateral sensory loss and weakness of UMN type, cognitive problems, and contralateral homonymous hemianopsia.
More distal stem damage: UE and face symptoms more than LE
When dominant (left mostly) hemisphere affected – aphasia may occur
When non-dominant (right mostly) hemisphere affected, problems with prosody or unilateral visuospatial deficits may occur. also neglect
Lacunar Syndrome
Lacunar Syndromes
Lacunar syndromes result from occlusion of small, Penetrating branches off of main arterioes
Most lacunar syndromes are correlated to consequences of hypertension and diabetes, not to artherosclerosis of these small vessels
Although small can still have very devastating consequences
- Sensory and/or motor deficits occur
- NO cognitive deficits
- Face, leg, arm typically affected equally (motor and sensory) as pathways are tightly packed in the interal capsule
PCA
Territory:
Med. And inf. Temporal/occipital lobes, midbrain thalamus
supplies:Cerebral cortex
*Ischemic stroke
BILATERAL Occlusion occurs with Single embolic or thormbolic occlusion of upper basilar artery
UNILATERAL Occlusion leads to contralateral homomunous hemianopsia (may present with macular sparing)
When dominant (mostly left) hemisphere damage:
alexia (inability to see words or to read),
anomia (a form of aphasia in which a patient is unable to recall the names of everyday objects),
visual agnosia (cannot recognize or interpret visual information – man who mistook his wife for a hat)
BILATERAL PCA Infarction
occurs with: single embolic or thrombotic occlusion of basilar artery
Results in:
bilateral homomynous hemianopsia (cortical blindness)
inferomedial temporal lobes infarcted: severe memory problems
prosopagnosia (cannot recognize faces – mary jane)
*NO MOTOR/SENSORY LOSS
ACA
territory: Ant. med. Cerebral hemisphere, ant. corpus callosum, caudate nucleus, internal capsule
supplies: Cerebral cortex
Part of the circle of Willis (more variability in symptoms)c
Less common than MCA
Ischemic Stroke
Mainly embolic, rarely due to atherosclerosis
Note: A thrombus is formed after a blood vessel is broken, and platelets help it clot! When a piece of a thrombus breaks off and travels to a different part of the body, it is called an embolus. An embolus is a blockage cuasing piece of material inside a blood vessel (can be a thrombus, fat globule, gas, or foreign material).
Athersosclerosis: hardening of the artery wall due to plaque.
symptoms and damage
STEM: damage at stem may not cause any damage due to connection with anterior communicating collateral
CORTICAL BRANCHES: Involvement of cortical branches of one ACA causes UMN weakness & cortical type sensory defiticits mostly CONTRAlateral LE and bowel and bladder dysfunction.
BILATERAL ACA INFARCTION:
Due to anomaly of circle of Willis.
Resultant cortical sensory-motor syndrome involving both LE
Severe behavioral disturbance with wide oscillations of affect and personality
May also cause apraxia (inability to perform particular purposeful action)
MCA (middle cerebral artery)
Internal capsule, thalamus, basal ganglia
Cerebral cortex
Most common site for strokes
Ischemic strokes
Cortical branches: contralateral sensory loss and weakness of UMN type, cognitive problems, and contralateral homonymous hemianopsia.
More distal stem damage: UE and face symptoms more than LE
When dominant (left mostly) hemisphere affected – aphasia may occur
When non-dominant (right mostly) hemisphere affected, problems with prosody or unilateral visuospatial deficits may occur. also neglect
Carotid Border-Zone
Carotid Border Zone
Territories:
Distal MCA, and ACA territories
Supplies:
Watershed area
Carotid artery dysfucntion resulting from hypoperfusion to distal MCA and ACA territories.
IC must be 70% occluded in order to produce carotid-border zone syndrome
Carotid border-zone syndrome:
Maximal ischemia occurs in the watershed areas as it requires the greatest pressure for blood to reat the terminal ends of ther artieres.
More cognitive in nature
Lacunar Syndromes
Lacunar syndromes result from occlusion of small, Penetrating branches off of main arterioes
Most lacunar syndromes are correlated to consequences of hypertension and diabetes, not to artherosclerosis of these small vessels
Although small can still have very devastating consequences
Sensory and/or motor deficits occur
NO cognitive deficits
Face, leg, arm typically affected equally (motor and sensory) as pathways are tightly packed in the interal capsule
PCA
Territory:
Med. And inf. Temporal/occipital lobes, midbrain thalamus
supplies:Cerebral cortex
*Ischemic stroke
BILATERAL Occlusion occurs with Single embolic or thormbolic occlusion of upper basilar artery
UNILATERAL Occlusion leads to contralateral homomunous hemianopsia (may present with macular sparing)
When dominant (mostly left) hemisphere damage:
alexia (inability to see words or to read),
anomia (a form of aphasia in which a patient is unable to recall the names of everyday objects),
visual agnosia (cannot recognize or interpret visual information – man who mistook his wife for a hat)
BILATERAL PCA Infarction
occurs with: single embolic or thrombotic occlusion of basilar artery
Results in:
bilateral homomynous hemianopsia (cortical blindness)
inferomedial temporal lobes infarcted: severe memory problems
prosopagnosia (cannot recognize faces – mary jane)
*NO MOTOR/SENSORY LOSS
ACA
territory: Ant. med. Cerebral hemisphere, ant. corpus callosum, caudate nucleus, internal capsule
supplies: Cerebral cortex
Part of the circle of Willis (more variability in symptoms)c
Less common than MCA
Ischemic Stroke
Mainly embolic, rarely due to atherosclerosis
Note: A thrombus is formed after a blood vessel is broken, and platelets help it clot! When a piece of a thrombus breaks off and travels to a different part of the body, it is called an embolus. An embolus is a blockage cuasing piece of material inside a blood vessel (can be a thrombus, fat globule, gas, or foreign material).
Athersosclerosis: hardening of the artery wall due to plaque.
symptoms and damage
STEM: damage at stem may not cause any damage due to connection with anterior communicating collateral
CORTICAL BRANCHES: Involvement of cortical branches of one ACA causes UMN weakness & cortical type sensory defiticits mostly CONTRAlateral LE and bowel and bladder dysfunction.
BILATERAL ACA INFARCTION:
Due to anomaly of circle of Willis.
Resultant cortical sensory-motor syndrome involving both LE
Severe behavioral disturbance with wide oscillations of affect and personality
May also cause apraxia (inability to perform particular purposeful action)
MCA (middle cerebral artery)
Internal capsule, thalamus, basal ganglia
Cerebral cortex
Most common site for strokes
Ischemic strokes
Cortical branches: contralateral sensory loss and weakness of UMN type, cognitive problems, and contralateral homonymous hemianopsia.
More distal stem damage: UE and face symptoms more than LE
When dominant (left mostly) hemisphere affected – aphasia may occur
When non-dominant (right mostly) hemisphere affected, problems with prosody or unilateral visuospatial deficits may occur. also neglect
