Neurological disorders & stroke Flashcards
8 kinds of diseases
VITAMINS (vascular, infectious, traumatic, autoimmune, metabolic, idiopathic, neoplastic, seizure)
5 things you need to know about a disease
epidemiology, prognosis, pathophysiology, clinical features, treatment
Cerebrovascular supply
brain receives blood from the internal carotid arteries (located at the bifurcation on the neck and branches into the MCA and ACA) and vertebral arteries
Posterior circulation
supplies the posterior cortex of the brain (occipital lobe, cerebellum, brain stem) and some subcortical structures
Arteries responsible for posterior circulation
posterior communicating artery (PCoA), thalamoperforating arteries, medial and lateral posterior choroidal arteries
3 cerebral arteries
anterior (for anteromedial region), middle (for lateral region), posterior (medial and lateral regions of posterior cerebrum) cerebral arteries
Deficits from right ACA stroke
behavioral changes (e.g. apathy), left-side deficits (e.g. hemiparesis, hemiplegia)
Deficits from left superior MCA stroke
Broca’s aphasia (frontal lobe), right upper extremity weakness and spasticity
Deficits from basilar artery stroke
located before the split so bilateral deficits, not cerebellar like ataxia and scanning speech
2 types of strokes
ischemic and hemorrhagic
Ischemic stroke
clot blocking blood flow to an area of the brain (e.g. plaque buildup or atherosclerosis, embolism); most common kind
Hemorrhagic stroke
bleeding inside or around brain tissue due to rupture in a blood vessel from too much pressure
5 subtypes of hemorrhagic stroke
intracerebral, aneurysm, epidural, subdural, subarachnoid
3 most common sites of an aneurysm
anterior communicating artery, posterior communicating artery/internal carotid artery, middle cerebral artery
2 surgical interventions for aneurysms
clip and coil
4 major causes of disability and death
heart disease, cancer, accidents, aneurysms
Incidence and risk of aneurysms
increases with age; risk factors modifiable (e.g. hypertension, diabetes, smoking, sodium intake)
What increases the risk for each type of stroke?
anticoagulant medications increase risk for hemorrhage; atrial fibrillation increase risk for ischemic stroke
2 regions involved in pathophysiology of ischemic stroke
penumbra and ischemic core
Penumbra
injured brain tissue around the ischemic core that is somewhat deprived of nutrients and eventually dies if not treated
Ischemic core
the structural lesion or irreversibly damaged brain tissue due to cell death
Pathophysiology of hemorrhagic stroke
midline shift or displacement of brain tissue across the centerline of the brain (e.g. left hemisphere moves into right)
Clinical presentation of acute strokes
focal unilateral deficits
Clinical presentation of hemorrhagic strokes
headache, vomiting, severe hypertension, coma
