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23 Cards in this Set
- Front
- Back
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Middle Cerebral Artery |
- supplies blood to the lateral cerebrum; largest supplying artery - damage causes aphasia/apraxia/reading and writing difficulties/sensory disorders; FACE and ARMS |
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Posterior Cerebral Artery |
supplies the occipital lobe; damage causes hemiopia; effects the vagus/faccial/hypoglossal |
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Anterior Cerebral Artery |
- supplies the frontal/parietal/superior medial - damage causes paralysis of LEGS and feet/gait apraxia |
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Stroke |
- a sudden onset of focal deficiency - 3rd most common cause of death - results from infarct or haemorrhage - Face, Arms, Speech, Time
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Stroke Risk Factors |
- Hypertension - Cardiac Disease - Cholesterol - Alcohol/Drug abuse - Diabetes |
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Infarct - Ischemia |
- 85% of strokes - BLOCKAGE of circulation - Thrombus/Embolism - NO oxygen or nutrients - Tissue damage/death - Severity depends on: speed of onset and collateral circulation |
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Haemorrhage |
- RUPTURE/BLEED - Primary Intracranial/Subarachnoid - Toxic and Pressure effects -REDUCED oxygen and nutrients - Severity depends on: speed of onset and volume/pressure
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Atherosclerotic |
- plaque forms on walls causing surface rupture - local clot ( thrombus) can block the blood flow, forming a blood clot, so the blood doesn't spill out |
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Aneurysm |
- causes a subarachnoid haemorrhage - weaked vessel wall at the site of plaque - ruptures easily; especially with high blood pressure - increased risk is size is >10mm or if previous aneurysm - the breakdown of products of iron is toxic to the brain |
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Cartoid Stroke |
- Anterior Cerebral Artery and Middle Cerebral Artery - causes hemiopia, hemiplegia, dysphaasia, deterioration,, of consciousness
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Vertebrobasilar |
- Posterior Cerebral Artery - causes diplopia, ataxia, dysarthria, paraesthesia(tickling, tingling, burning sensation) |
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Total Anterior Circulation Stroke: TACS |
- effects higher cerebral function (dysphasia,dyscalcia, visiospatial neglect, hemiopia, motor +/- sensory deficit - poor chance of functional outcome |
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PACS |
- 2 out of 3 TACS - Variable outcomes - high chance of early recurrence
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LACS |
- 1 out of 3 TACS - most common -pure motor/sensory/sensorimotor deficits -no higher cerebral function signs - variable outcome - high chance of early recurrence |
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POCS |
- usually only partial; if complete = dead - Cranial nerve palsys cerebellar signs - isolated hemiopia high chance of good function - risk of recurrence in the first year |
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Subarachnoid Haemorrhage |
- < 65yrs; F>M - Precipitants: physical exertion and straining, high blood pressure - caused by Aneurysm - migraine like with no visual auras |
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Clinical Features : Aneurysm |
- HEADACHE (occipital), sevever, sudden onset - nausea and VOMITING - coma - photophobia - seizure - Kernig's Sign - focal neurological signs - History of trauma/family hx aneurysms
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D.A.S.H.I.N.G. |
Dysdisdochokinesis Ataxia Slurred Speech Hypotonia Intention Tremor Nystagmus Gait Abnormality |
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Dysdiadochokinesis |
impaired rapidly alternating movements |
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Transient Ischaemic Attack (TIA) |
- sudden onset - resolves in ~ 24 hours with no residual deficit - >80% Cartoid territory (anterior circulation) - focal symptoms due to inadequate blood flow (embolism) - warning episodes = can be prevented |
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TIA Investigations |
- CT or MRI - CT Angiography or Neck Ultrasound - Blood Tests ( glucose, lipids, cholesterol, clotting) - Urinalysis (glucose, protein) |
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TIA Treatment |
- Hydration/Oxygenation - Insulin to normalize high glucose levels - Asprin 300mg - Decompressive surgery |
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TIA Rehabilitation |
- Multidisciplinary Team - Communication: patient and family, interprofessional -Promote Intrinsic Recovery (nervous system) - Assist Adaptive Recovery (re-learning or acquire new techniques) - Prevent complications/minimize disability |
