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?
- 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
- 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
- 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
– 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
- 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.
due to BILATERAL OCCIPITAL-PARIETAL LESIONS