Chapter 13: vascular cognitive impairment

Question 1

Embolic cerebral infarct (stroke)

Answer 1

A blood cloth in the artery. Can cause drooping face, loss of body functions and difficulty speaking.

Question 2

Transient Ischemic Attack (TIA)

Answer 2

Temporary reduction of blood flow to the brain. Neurological symptoms disappear within 24 hours.

Question 3

Lacunar infarct (TIA)

Answer 3

A type of TIA in the arteries that supply the brains deeper structures, after which a smaal cavity (lacuna) forms. Can lead to motor impairments, loss of sensation or dysarthria if it happens in the thalamus or pons. Symptoms disappear within weeks to months.

Question 4

Intracerebral hemorrhage (bloeding)

Answer 4

A ruptured blood vessel causes bleeding in the brain. Causes loss of consciousness, confusion and disorientation.

Question 5

Subarchnoid hemorrhage (bloeding)

Answer 5

A bleeding between the meninges (layers) of the brain. Causes headache, neck stiffness, hypersensitivity, loss of consciousness and nausea.

Question 6

Oedema

Answer 6

Fluid in the brain surrounding the hemorrhage (bloeding). Associated with cognitive impairments in memory, information processing, attention and executive functions.

Question 7

Cerebral small vessel disease

Answer 7

Damage to the white matter tracts (present in 90% of >80 year olds)

Question 8

Anterograde amnesia

Answer 8

Not being able to form new memories.

Question 9

Aphasia

Answer 9

Impairment of the language system.

Question 10

Major stroke

Answer 10

Mostly causes anterograde amnesia and aphasia.

Question 11

Apraxia

Answer 11

Inability to carry out meaningful movements.

Question 12

Hemispatial neglect

Answer 12

Deficit in attention to one side of the body. If there is damage in the right hemisphere, the left side of the body / visual field is neglected (contralateral).

Question 13

Ideomotor apraxia

Answer 13

Unable to make meaningful movements while knowing what movement would be appropriate / recognizing the purpose of a certain tool.

Question 14

Supply area of the middle cerebral artery (MCA)

Answer 14

About 80% of the strokes occur here. The MCA is the largest cerabral artery and supplies blood to the frontal, temporal and parietal areas, but also deeper brain structures like the talamus. Can cause language impairment, memory impairment and apraxia.

Question 15

The PCA supplies blodo to the temporal and occipital lobes. An infarct in the PCA can lead to:

Answer 15

• Hemianopsia
• Quadrantianopia
• Prosopagnosia
• Visual agnosia
• Agraphia
• Alexia

Question 16

Hemianopsia

Answer 16

Being blind in half of the visual field.

Question 17

Quadrantianopia

Answer 17

Being blind in a quarter of the visual field.

Question 18

Prosopagnosia

Answer 18

Not being able to recognize faces.

Question 19

Visual agnosia

Answer 19

Not being able to recognize objects.

Question 20

Agraphia

Answer 20

Ibability to write

Question 21

Alexia

Answer 21

Inability to read

Question 22

The ACA supplies blood to the dorsal an medial parts of the frontal parietal lobe. Damage in the ACA can lead to:

Answer 22

• Impairment in language functions, inhibitions deficits, impairments in planning and can change behaviour and emotions.

Question 23

Transcortical aphasia

Answer 23

Not being able to communicate verbally or process written language, but being able to repeat sentences.

Question 24

Subcortical infarcts

Answer 24

About 50% experience cognitive impairments, mostly in motor control, memory and attention deficits.

Question 25

Vascular dementia

Answer 25

Cognitive impairment in at least one domain and significant interference with activities of daily living. Most people have problems with executive functions, attention, information processing speed, memory, language or visuospatial functions.

Question 26

Bradyphrenia

Answer 26

Slowness in thinking