TRANS 065: STROKE SYNDROMES Flashcards
Most common of the Types of stroke, some textbooks says 85-87% of stroke.
ischemic
Although the Intracerebral and subarrachnoid have lower prevalence than Ischemic stroke, they have higher mortality rate. T or F?
T
TOAST Criteria?
- Large artery atherosclerosis
- Cardioembolism
- Small vessel occlusion (lacune)
- Stroke of other determined etiology
- Stroke of undetermined etiology
The Internal Carotid artery bifurcates into
ACA and MCA
The Vertebral artery merges to form the
Basilar Artery
In the top of Basilar artery we have 2 pairs.
Superior Cerebellar artery and Posterior Cerebellar Artery”
From the origin to the bottom of Sylvian Fissure is what segemetn of MCA?
M1
• Right sided weakness, face, arm>leg, sometimes hemisensory deficit
• Conjugate eye deviation to left (cortical sign towards the lesion)
• Expressive aphasia
Most of us the dominant brain is the left resulting to Broca’s area on the left. The Broca’s area is affected. Broca’s area is for speech expression becoming nonfluent aphasia. This patient have normally intact comprehension but unable to express themselves very well.”
what vessel?
LEFT MCA STROKE ANTERIOR (SUPERIOR) DIVISION
what vessel
Signs & Symptoms: • Left sided weakness: face, arm > leg • May have hemisonsory deficit • Eyes deviate to right • Neglect Neglect different from deficit. Deficit means you loss it, Neglect meaning you don't have it and you cannot pay attendtion to that. In testing the patient's arms separately, they can feel it, but when tested simultaneously the patient neglect left side of the body (extinction)." • Aprosody No emotional part of speech, the way they talk differ from their emotion. They cannot show the anger or happiness in their speech"
RIGHT MCA STROKE ANTERIOR (SUPERIOR) DIVISION
what vessek?
Signs & Symptoms:
• Right hemiparesis: mild/transient
• Right Homonymous hemianopia: Upper quadrantanopia
Optic radiation is involved. If the stroke is smaller, patient can have only quadrantanopia”
• Comprehensive aphasia (Wernicke’s aphasia/fluent/receptive aphasia)
These people are very happy and just say whatever comes to their mind spontaneously.”
LEFT MCA STROKE POSTERIOR (INFERIOR) DIVISION
what vessel?
Signs & Symptoms:
• Left hemiparesis: mild/transient
• Left homonymous hemianopia: Upper quadrantanopia
• Hemi-neglect
90% of attention comes from the right side of the brain. If you have a right posterior stroke they then to have neglect or extinction”
• Apraxia
• Delayed depression
40-50% of patient develops some sort of depression”
RIGHT MCA STROKE POSTERIOR (INFERIOR) DIVISION
Signs & Symptoms:
• Motor deficit
o Contralateral leg, distal > proximal weakenss
o Mostly spare arm and face
o Both ACAs: Paraparesis/plegia
• Sensory:
o Mild: in the affected leg
• May have other symptoms
o Mutism (patient don’t want to move or do anything)
o Akinetic mutism or aboulia
• Decreased spontaneous activity and speech
• Prolonged latency in responding to questions/directions
• Restlessness
o Hyperactivity
o Agitation
ACA
Medial temporal lobe and Occipital lobe is supplied by
PCA
Signs & Symptoms: • Contralateral Visual Field Deficits: Homonymous hemianopia or Quadrantonopia • Visual agnosia • Visual hallucination • Headache/Dizziness/Confusion
PCA
Signs & Symptoms: • Dizziness: 75% • Nausea or vomit: 50% • Ataxia, dysarthria, nystagmus: 90% • Headache (more in PICA stroke) • Incoordination/balance issue
cerebellar artery
most common cause of cardioembolims?
Afib/aflutter
they say that this is one of the most severe or most grave stroke; we can’t do anything, patient can be locked-in, meaning they block everything from the neck down.
deep basilar artery
is a rare neurological disorder in which there is complete paralysis of all voluntary muscles except for the ones that control the movements of the eyes.
locked in syndrome
waht tx? up to 4.5 hours from onset or last known well
IV Alteplase
“ when you have a large vessel stroke, IV-tPA can act very poorly; they can open the blood vessel to about maximum _____%
30%