Week 3 Flashcards
(76 cards)
Stroke: acute signs
Sudden onset
* Headache
* Loss of mental abilities (motor, language, memory)
* Loss of strength or paralysis
* Confusion, disorientation, consciousness
A CT scan is required to make the distinction between
haemorrhage and infarct
Blood shows up white on a normal CT
risk factors stroke
age >65
hypertension
vascular cognitive impairment
covers the whole spectrum of cognitive consequences of vascular disease.
Roughly corresponds with the division of the DSM-5 into mild and major neurocognitive disorders
Cerebral vascular accident
Ischemic Stroke (infarct): a blockage that stops the flow of blood and this stops the oxygen
Hemorrhagic Stroke: a bleeding that puts pressure on local areas
CT scan for stroke
- A fluid is injected into the bloodstream
- On the scan you can see that a bloodstream stops
- You have to know which stroke it is, because if you give a compound that stops the blockage,
you kill the patient, because the bleeding can develop further. - Only 20% is a haemorrhage
Hemorrhagic Stroke
- Occurs more often in older people with high blood pressure
- Intracranial bleeding can also occur after aTBI, a tumour, degenerative
conditions, arteriovenous and malformation - Acute treatment is often conservative (they might not do anything, you will just be monitored)
- Medication to reduce swelling
- Surgery to relieve pressure on the brain
Cerebral infarct
- blood clot closes an artery in the brain -> reduces oxygen supply to closed-off parts.
common: drooping of the face
- loss of function (one side of the body), difficulty speaking
less common: decreased vision, coordination problems, headache, fainting.
What are risk factors of cerebral infarct
- hypertension
- high cholesterol
- type 2 diabetes
- obesity
- arteriosclerosis
- atrial fibrillation
- smoking
- inactivity
How is the cerebral infarct treated
- intravenuous thrombolytic therapy (drugs are used to dissolve the clot)
- or endovascular treatment (microcatheters are inserted into the brain from the groin to remove the blood clot mechanically)
Transient Ischemic Attack (TIA)
- temporary reduction in blood flow to a small part of the brain, and neurological symptoms disappear withing 24 hours.
- increasing the risk of a second stroke
- no brain abnormalities are found
Lacunar infarct
an infarct in the small arteries that supply the brain’s deeper structures, after which a small cavity forms.
- no clinical manifestation
- if it happens in the thalamus/pons it can lead to temporary motor or sensory impairments.
- risk factor for dementia
Cerebral haemorrhage
a blood vessel in the brain ruptures.
symptoms:
- reduces consciousness
- confusion
- disorientation
The bleeding is into the brain tissue (intracerebral) treatment focusses on lowering the blood pressure in the brain, this helps to stop the bleeding
What is it called when the bleeding occurs within the meninges surrounding the brain
subarachnoid haemorrhage (SAH)
Caused by ruptured intracranial aneursym.
- treatment is either endovascular (closed by platinum coils inserted through the groin) or neurosurgical (closed with a metal grip)
What is the difference between cognitive disorders in haemorrages and infarcts
in hemorrhages cognitive disorders are mainly related to the severity and the size of the haemorrage
In infarcts the location is more important
What are vascular risk factors and why do they matter for the brain?
Vascular risk factors = Type 2 diabetes, hypertension, obesity, high cholesterol
🧠 These increase your risk of cognitive decline and dementia, and generally lower brain function.
They mess with your brain’s plumbing—literally.
What is CSVD and how does it affect the brain?
🩸 CSVD = Cerebral Small Vessel Disease
🧠 It’s damage to the tiny blood vessels in the brain → leads to white matter damage (aka leukoaraiosis)
This damage = slower thinking, worse memory, and overall fuzzier brain
🚶♀️It’s also part of normal aging… but vascular risks speed it up!
What’s a TIA and how does it mess with your thinking?
🧠 TIA = Transient Ischemic Attack (a.k.a. “mini stroke”)
🔁 Most people get mild cognitive issues after a TIA (like slow memory or poor focus), and a few get severe ones.
🎯 Hits: attention, memory, processing speed, and executive functions (like planning & decision-making)
👵 Age = BIG risk factor.
What’s the brain’s vibe after a major stroke?
2 out of 3 people have cognitive issues after a major stroke.
🧩 Problems can happen anywhere in the brain depending on where the stroke hits.
🚫 Common issues:
Attention & focus
Memory (especially anterograde amnesia = trouble making new memories)
Executive function
Language (aphasia)
📉 These impairments slow down recovery & affect quality of life big time
How are all these conditions connected?
💡 Vascular risk factors → CSVD → white matter damage → cognitive decline
💥 Stroke or TIA = major events that worsen cognitive function
📉 All roads lead to attention, memory, speed, and planning issues—because the brain works like a network, and when one part is down, others struggle too.
Why are thalamic infarcts kind of weird?
Because the thalamus is the brain’s traffic control center!
🧭 It connects speech, motor, sensory, and memory areas.
💥 So when it’s damaged (aka infarct), you get a strange combo of symptoms—like a glitchy control panel.
What’s the thalamus actually doing in the brain?
🔁 It’s the relay station—sending signals between the body and different brain parts.
🎙️ Touch, sound, motor control, memory—everything checks in with the thalamus on the way to its destination!
What are the three main arteries supplying the brain?
he Big 3 Brain Arteries:
Anterior Cerebral Artery (ACA) – feeds the front & top parts
Middle Cerebral Artery (MCA) – feeds the sides (BIG player in strokes)
Posterior Cerebral Artery (PCA) – feeds the back (including vision areas)
🎯 Each one feeds different brain parts, so infarcts here = different deficits.
Consequences of a stroke in the middle cerebral artery
- memory impairments (especially anterograde amnesia)
- In the language dominant hemisphere can lead to language impairment
- Apraxia (inability to carry out important movements)
- In the acute phase after an MCA stroke -> patients experience neglect
- In the chronic phase -> neglect recovers but extinction and impaired body orientation often remains.
Damage to the posterior cerebral artery leads to:
supply blood to the occipital and temporal lobes
- hemianopsia and quadrantanopia (impairments of half or a quarter of the visual field on the contralateral side)
- visual agnosia (impaired recognition of objects), color agnosia, prosopagnosia (impaired facial recognition)
- Anton’s syndrome: patients are unaware of their blindness and deny this
- problems with writing and reading (agraphia and alexia)
