Strokes + Rehab Flashcards
(36 cards)
Definition of Aphasia
Inability to formulate +/or comprehend language
Definition of Dysphasia
Impairment of language due to brain damage
What is receptive Dysphasia
Inability to understand (Wernickes)
What is expressive dysphasia
Inability to formulate language but has full understanding (Brocas)
What is dysarthria
Inability to speak due to motor disturbances of face and tongue muscles
Main differentiation between dysphasia = reading/writing unaffected
May exist alongside dysphasia
What is dyspraxia
Inability to respond voluntarily in conversation but may reflexively speak (e.g. may greet you but not be able to answer any questions)
What is dysphagia and whats its prevalence post-stroke
swallowing issues, must be a problem in the oral, pharyngeal or oesophageal stages of swallowing
30-50%
What must be done once dysphagia is identified
PT, SALT, OT + dietitians must be made aware and nurses/HCA may have to assist eating
What are the higher cognitive impairments post stroke
- Sensory Neglect (unilaterally sensation is ok but bilaterally there is a unilateral decrease in sensationon affected side)
- Agnosia (can’t recognise familiar objects)
- Asterogosis (can’t recognise numbers drawn on a hand)
- Dyspraxia
- Homonymous Hemianopia
- Dysphasia
- Visuospatial neglect
- Decreased Conciousness
Risk Factors for Stroke
HT Cholesterol Diabetes Smoking Alcohol Poor Diet Low Exercise Increased BMI AF Drugs (IVDU + Warfarin) Age Male PHx FHx
How do you classify stroke
Bamford classification
How do you identify a Total anterior circulation stroke (TACS) using the Bamford classification + state its prevalence
20% of all Ischemic strokes All 3 of: Evidence of higher dysfunction Motor/Sensory Defect to contralateral face, arm + leg Homonymous Hemianopia
How do you identify a Partial anterior circulation stroke (PACS) using the Bamford classification + state its prevalence
35% of all ischemic strokes
2/3 of:
Evidence of higher dysfunction (e.g. dysphasia)
Motor/Sensory Defect to contralateral face, arm + leg
Homonymous Hemianopia
How do you identify a Lacunar stroke using the Bamford classification + state its prevalence
20% of ischemic cases ONE of: Pure Motor symptoms Pure sensory symptoms Purely Sensory Motor symptoms Ataxic Hemiparesis
No: New Dysphasia New Visuospatial problem Proprioceptive loss only Vertebrobasilar Fractures
How do you identify a Posterior Circulation stroke (POCS) using the Bamford classification + state its prevalence
25% of Ischemic cases ONE of: Cranial Nerve Palsy + Contralateral motor/sensory deficit Bilateral Motor/Sensory Deficit Conjugate eye movement problems Cerebellar dysfunction Isolated Homonymous hemianopia
Prevalence of Haemorrhagic stokes vs Ischemic Strokes
15% vs 85%
Risk factors for Haemorrhagic Strokes
On anticoagulation Thrombophillic Depression Severe Headache HT (+++) Vomiting Diabetes
Primary Causes of haemorrhagic strokes
HTN
Amyloid
Angiopathy
Secondary causes of haemorrhagic strokes
Underlying lesion coagulopathy
How to treat haemorrhagic strokes
Reverse any anticoagulant
Stop antiplatelet
Stabilise (decrease BP if possible)
Emergency Neurosurgery
What are some common stroke mimics
Migrane Space-occupying Lesion Seizure Syncope Metabolic disturbance Peripheral neuropathy Cervical Spine Pathology Transient Global Amnesia Psychiatric Conditions
What is the timeframe to get a CT/MRI of a ?stroke
<12hours
What are some indications for an urgent scan
On anticoagulation Bleeding disorder Fluctuating/Progressive Symptoms Decreased Consciousness ?SAH
What are the signs of an infarct on a CT
Hyperdense MCA
Loss of Gray/White Differentiation
Sulcal Effacement (erasure)
Loss of insular ribbon (part of cortex)
