Lecture 11 - Stroke Syndromes Flashcards Preview

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Flashcards in Lecture 11 - Stroke Syndromes Deck (17):

What are the four types of intracranial haemorrhages?

1. Epidural hematoma (EDH)
2. Subdural hematoma (SDH)
3. Subarachnoid haemorrhage (SAH)
4. Intracerebral or intraparenchymal haemorrhage (ICH)


Describe subdural haematoma

- bleeding between dura and arachnoid
- usually due to rupture of vein - so more slow etc
this is more common with age
- can be chronic, usually in elderly, where their brain is atrophied with age, so more space for blood
- can be acute - associated with severe injuries - worse outcome than chronic, but will be fine if you deal with it quickly.


describe subarachnoid haemorrhage

- between arachnoid and pia
- nontraumatic and traumatic


Describe a nontraumatic/spontaneous subarachnoid haemorrhage

"worst headache of my life"
- usually caused by the rupture of an arterial aneurysm in the subarachnoid space
- also could be called by AVM


What are berry aneurysms

aneurysms that look like a berry.
usually arise around the circle of willis, particularly at the bifurcations


What is an aneurysm

Balloon-like outpouchings of the vessel wall that usually have a neck connecting it to the vessel.

-usually arises in the anterior circulation (carotid arteries and its branches)


What puts people at risk of aneurysm rupture?

- hypertension
- smoking
- situations causing sudden elevated bp - eg exercise


Describe traumatic subarachnoid haemorrhage

Caused by bleeding vessel into the subarachnoid space, due to traumatic injury or contusion


Descrive AVM

Ateriovenous malformation

- important cause for nontraumatic intracerebral haemorrhage
- congenital abnormalities where there are abnormal direct connections between arteries and veins forming a tangle of blood vessels
- best seen on cerebral angiography
- can also cause seizures, migrianes.
- usually removed if affects functioning and behaviour eg. language.


describe intracerebral haemorrhage

aka intraparenchymal

- within the brain hmispheres, brainstem, cerebellum or spinal cord
- traumatic - contusions can cause bleeding in white matter
- non traumatic - hypertension, brain tumors, secondary haemorrhage after ischaemic infarction, AVM, etc.

these are more commonly the cause of stroke syndromse


name the order of the homonculusf from bottom of frontal lobe up

face - hand - arm - trunk - leg - foot


Difference between ischaemic and haemorrhage

ischaemic - blockage
haemorrhagic - explosion of blood


how does the PCA affect memory?

it supplies to the hippocampus, parahippocampal gyrus, mammilary body and mammilothalamic tract, and thalamus.

- usually need bilateral

– L – verbal amnesia; colour, object agnosia
– R – visuospatial, faces, locations, navigation


Describe a thalamic stroke

– Memory loss +
• Wide range of neuropsychological features – Arousal
– Attention
– Motivation
– Initiative
– Executive function


what is the visual syndrome of PCA infarct

anton-babinski syndrome - visual anosognia - cortically blind but think they can see

.. sometihng about lacunae infarcts


Balint's syndrome?

clinical triad:
- optic ataxia - cant reach for objects, but can see and recognise them. movement problem

- psychic paralysis of gaze - can't visual scan or maintain fixation on object - eyes wander

- simultanagnosia - not able to perceive more than one object at time.



What is collateral circulation

if you compromise one vessel, benefit of the circuit of willis is that all of the surrounding vessels can cope by…getting around somehow…