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26 Cards in this Set
- Front
- Back
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What are the immediate effects of a TBI?
(right after regaining consciousness) |
Disorientation
Poor attention Post-traumatic amnesia |
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What are the long term effects of a TBI?
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Difficulty with abstract though and conceptualization
Decrease in attention decrease in cognitive flexibility decrease in planning ability decrease in longterm memory (interrhinal cortex/rhinal cortex) deficits in cognitive function performed by brain region at coup and countercoup sites |
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What are the behavior effects of a TBI?
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disinhibition
apathy loss of patience agitation or increase in temper emotional lability depression |
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What is a stroke?
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Sudden loss or change of neurological function persisting longer then 24 hours.
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What is a stroke that lasts less then 24 hours called?
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Transient Ischemic Attack
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What are the two types of stroke?
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Ischemic and Hemorrhagic
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What is an ischemic stroke?
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Loss of blood flow to a specific brain region due to blood vessel occlusion.
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What is a hemorrhagic stroke?
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Rupture of a blood vessel
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What is the annual incidence of stroke in the US?
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731,000
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What are the three leading causes of death in the US?
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1. Heart disease
2. Cancer 3. Stroke |
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What are the risk factors for stroke?
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Hypertension
Myocardial infarction (heart attack) Atrial fibrillation Diabetes Elevated cholesterol (atherosclerosis) A symptomatic carotid artery disease Cigarette smoking Excessive alcohol consumption Age Gender Race Previous Stroke or TBI |
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What are the two primary types of occlusion (ischemic stroke)?
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Thrombotic: Blood clot that obstructs a blood vessel
Embolic: mass of undissolved matter in a blood vessel from another source brought there by the blood current |
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What are the two principle sources of emboli?
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The heart
The carotid artery |
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What are the primary types of infarcts?
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Cortical: often involve the ACA, MCA, and the PCA
Lacunar: small, ischemic infarcts, deep in the brain (approx. 70% of vascular dementia patients) |
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What are the symptoms of a stroke and TIA?
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Sudden weakness, numbness, or clumsiness of arm, leg, or face on one side of the body
DIfficulty walking Difficulty speaking or comprehending Loss of balance or sense of spinning Double vision or temporary loss of vision, especially in one eye Sudden, severe headache Sudden confusion or memory loss |
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What is the treatment of TIA/Stroke?
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Reduce the risk factors (highly preventable)
Anticoagulants Platelet blocking drugs Endarterectomy (depends on degree of stenosis) |
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What are the treatments for Strokes?
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tPA (tissue plasminogen activator)
MERCI Retriever |
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What is tPA (tissue plasminogen activator)
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breaks up blood clots, ONLY for ischemic stroke, must administer within 3 hours of symptom onset
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Explain the MERCI Retriever
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Mechanical Embolus Removal in Cerebral Ischemia
First FDA-approved device to remove clots from the brain Cathetor through the femeral artery DEvice captures/removes clots |
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What is dementia?
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Acquired and persistent impairment of cognitive abilities.
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What is vascular dementia?
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Dementia due to cerebrovascular disease
There is very competing diagnostic criteria that has a lot of impact of the research and treatment |
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What are the different diagnostic Criteria for VAD?
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HIS: Hachinski Ischemia Score
DSM-IV: Diagnostic and Statistical Manual of Mental Discorders, 4th ed. ADDTC: Alzheimer's Disease Diagnostic and Treatment Centers NINDS-AIREN: National Institute of Neurological Disorders and Stoke. Association International pour le Recherche et l'Eseignement en Neurosciences |
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What is the prevalence of VAD?
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Accounts for about 15% of all dementia cases.
About 25%-33% of all people who've had a first stoke have VAD within 3 months. BUT, prevalence varies by diagnostic criteria (5.1%-25.7% |
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What are the clinical characteristics of VAD?
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Usually an abrupt onset.
Abnormal signs on a neurological exam. Stepwise deterioration Depression Personality changes Patchy distribution of cognitive deficits that varies from pt to pt DEPENDS ON THE SPECIFIC DISTRIBUTION OF THE VESSELS INVOLVED |
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What are the cognitive characteristics of VAD?
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Highly variable (size, number, and location)
Influence of diagnostic criteria (memory impairment not necessarily required) Need for more research |
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VAD vs. Alzheimer's disease
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charact VAD AD
onset abrupt gradual course stepwise progressive memory retrieval encoding exec. prominent mild processing slow normal affect depressed apathy |
