Modifiable risk factors for stroke
HBP (hypertension) Atrial fibrillation (heart disease) Diabetes Atherosclerosis Blood cholesterol levels High alcohol consumption Head/Neck injuries Infections Cigarette smoking Stroke belt in USA
Non-modifiable risk factors for stroke
Age (every decade after 55, risk doubles) Gender (males more likely) Race/ethnicity Family history/genetic tendency Previous CVA/TIA
TIA
"mini stroke" or "brain attack" Temporary occlusion stopping blood flow No permanent injury to brain Causes: blood clot in a brain artery or traveling clot, injury to blood vessels, narrowing of blood vessel in brain Risk factors: HBP, atrial fib, diabetes, family hx, high cholesterol, age (over 55), race
Ischemic stroke
Occlusive Narrowing arteries
Hemorrhagic stroke
Bleed Leaks out of a vessel and damages/kills brain tissue
Etiology: Broca's aphasia (connectionist model)
Occlusion of ANTERIOR branch of MCA (middle cerebral artery)
Etiology: Wernickes aphasia (connectionist model)
Occlusion of POSTERIOR branch of MCA (middle cerebral artery)
Etiology: Global aphasia (connectionist model)
Occlusion of main trunk of MCA (middle cerebral artery) Damage in central region of the language dominant hemisphere (left side)
Nonfluent/telegraphic Distort consonants Misarticulated words Labored repetition Fair to good comprehension
Broca's
Fluent Verbal (semantic) prophase Poor word retrieval Poor comprehension
Wernicke's
Nonfluent Literal, verbal paraphasia Poor word retrieval Poor repetition Poor comprehension
Global
nipaut (dubeid) for hat
neologism
sweater for jacket
semantic paraphasia
babana for banana
phonemic
ima una dopido paluh noomi for .......?
jargon
hand for foot
semantic
yellow stick for pencil
literal interpretation
"little bit, little bit" for almost everything
perseverative stereotypy
fork for knife
semantic
hot hog for hot dog
phonemic
we went there, to buy you know, but then that one person, he went that way and it was too far so we had to you know,
circumlocution
heather and heather, no, heather, and the dog, um, went around, then uh, and park
agrammatic/telegraphic
i went there that one day but that was only there so he never came.
empty speech
"duck" for truck
phonemic
ask client to inhale different flavours/smells
CN I: olfactory
ask client to ID colors; count how many fingers holding up; obtain reading sample
CN II: optic
bring light from periphery to center of eye
CN III: occulomotor
follow finger as moves down/toward nose
CN IV: trochlear
check sensation in forehead, cheek, jaw
CN V: trigeminal
ask client to look at each of your ears one at a time
CN VI: abducens
