Week 3 Flashcards
Causes of Brain damage and Aphasia
- CVA
- Anoxia
- Tumor & Infection
- Brain Injury
- Hydrocephalus
- Degenerative Disease: AD, PPA
What do neurons need?
oxygen and glucose
Metabolism
Exchange of nutrients and waste products
3 Structural Levels of Neuroanatomy
- In neck: L/R common carotid arteries -> Internal carotid artery
- Circle of Willis
- ACA, PCA, MCA
MCA
- Emerges through the sylvian fissure
- In the left hemisphere, MCA supplies key language areas
Infarction
Death of Neural Tissue
Ischemic Stroke
- Most common, 87% of strokes
- Thrombosis: accumulation of atherosclerosis pletelts and fatty plaque (stenois), blocking the artery
- Embolism: build up of platelets and plaque break off a vessel wall and travel
Penumbra
Area surrounding infarction
Hypoperfusion
Reduced blood flow in penumbra, but intact tissue
Thrombolysis
“clot busting”
1. Administer tPA to preserve tissue
2. 3-4.5 hour window
3. Exclusion criteria
Diaschisis
- suspension of functions that depend on structures
far from the infarct - due to edema and hypoperfusion
Spontaneous Reperfusion
early recovery in the early days
Hemorrhage
Bleeding from ruptured vessels
artery bursts, more deadly
Headaches as a symptom
Intracerebral hemorrhage (ICH)
Subcortical
Subarachnoid
hemorrhage
- within the
meningeal membranes - Often due to a
ruptured aneurysm
Arteriovenous malformation
(AVM)
-where walls of the arteries become tangled
-Congenital condition
-Rare
-May or may not cause symptoms
-Can cause hemorrhage
Angiography
-Exposes arteries in head and neck
-Visual deficits
-Hemiplegia
-Use brain imaging
-Dye is injected into carotid artery
CT (Computerized Tomography)
-With/without contrasts
MRI
no radiation
MRA
for blood vessels
Pet scan
measures metabolism
Dissociation
- clear deficit in one skill while others are intact
- Not always a clear association between lesion and language deficits
Syndrome
a recurring pattern of symptoms
Mixed Transcortical Aphasia
*combination of TMA and TSA
* nonfluent; poor comprehension, good repetition (Similar to
global aphasia but intact repetition)
* Spoken language is often echolalia
* Repetition skills might be completely intact or mildly impaired
* Diffuse or multifocal damage in the frontal and parietal lobes
Crossed Aphasia
Aphasia following Right hemisphere stroke
Subcortial Aphasia
- aphasia following subcortical stroke
- thalamic -> word finding deficits
- vs. nonthalamic (but incl. basal ganglia) -> global, Broca’s, Wernicke’s…
Lateralization
Language centers lateralized to left hemisphere mainly
Anterior vs. Posterior (to central sulcus)
Non-fluent vs fluent
Sylvian vs extrasylvian
near sylvian fissure vs far from
conduction aphasia
Phonological working memory could impair repetition
Therapeutic Set
Ability to realize why they are doing therapy
-Wernicke’s has poor therapeutic set
Transcortical Aphasia and repetition
Good at repetition
