January 20, 2014 (1)

Occlusion most often causes contralateral gaze palsy

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: ( in and out of the brain) comes water (ionic difference) -cerebral swelling (edema) —all this cause ischemic core Consequences of MCA Occlusion Most often causes: • Contralateral gaze palsy • Hemiplegia – loss of movement in arm and trunk of one side of the body (does not usually include the leg) • Hemisensory loss • Spatial neglect - inability to report, respond, or orient to stimuli, in the contralesional space • Hemianopsia – decreased vision or blindness in half the visual field •Global aphasia (if on left side) •May lead to coma secondary to edema Caplan's Stroke (Fourth Edition)A Clinical Approach Imaging MCA occlusion A. Angiogram showing occlusion of the MCA. B, Recanalization of the MCA immediately after stent placement. Caplan's Stroke (Fourth Edition)A Clinical Approach Lenticluostriate Stroke • End arteries for the MCA • Therefore they have no collateral blood supply • Damage to the basal ganglia and the internal capsule • Can result in a “pure motor stroke” Caplan's Stroke (Fourth Edition)A Clinical Approach Consequences of ACA Occlusion Most often causes: • Incontinence – loss of bladder control • Contralateral hemiplegia – mainly in legs • Motor and sensory aphasia –lack of speech or meaningless speech • Contralateral weakness of leg, hip, foot and shoulder • Sensory loss in foot Caplan's Stroke (Fourth Edition)A Clinical Approach Imaging ACA Occlusion MRI FLAIR image showing a typical anterior cerebral artery cortical infarct located along the paramedian cerebral cortex. Caplan's Stroke (Fourth Edition)A Clinical Approach Consequences of PCA Occlusion Most often causes: • Contralateral hemianopsia – visual field loss • Larger infarcts involving the internal capsule and thalamus may cause hemisensory loss and hemiparesis due to disruption of the ascending and descending information passing through these structures Caplan's Stroke (Fourth Edition)A Clinical Approach Imaging of PCA Occlusion CT of a patient with acute vision loss in the left half of the visual field. The CT demonstrates an infarction in the contralateral visual cortex, i.e right occipital lobe. http://www.radiologyassistant.nl/en/p484b8328cb6b2/brain-ischemia-vascular-territories.html Hemorrhagic Stroke (15-20%) Hemorrhagic Stroke (15-20%) Intracerebral hemorrhage Blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells Subarachnoid hemorrhage Artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull Imaging Brain Hemorrhages CT Scan MRI Caplan's Stroke (Fourth Edition)A Clinical Approach Imaging Brain Hemorrhages Caplan's Stroke (Fourth Edition)A Clinical Approach Hemorrhagic Stroke Brain hemorrhages can result from many conditions that affect your blood vessels including •uncontrolled high blood pressure (hypertension) •weak spots in your blood vessel walls (aneurysms) Imaging aneurysms ACA MCA Caplan's Stroke (Fourth Edition)A Clinical Approach Stroke Signs of Hemorrhagic Stroke Airway compromise Complete unresponsiveness Complete aphasia Nausea & vomiting Signs of Ischemic Stroke Expressive aphasia Unilateral deficits Poor coordination Risk factors for stroke Risk issues you can do something about * Up to 80% of strokes can be prevented High blood pressure (hypertension) High blood cholesterol Diabetes Being overweight Excessive alcohol consumption Physical inactivity Smoking Stress Risk factors for stroke Risk factors you can't control Age Gender Family History History of stroke or TIA TIA • Transient ischemic attack (TIA) is a warning sign of a future stroke – up to 40% of TIA patients will have a future stroke • Symptoms of TIAs are the same as stroke • TIA symptoms can resolve within minutes or hours Stroke Recovery 10% of stroke survivors recover almost completely 25% recover with minor impairments 40% experience moderate to severe impairments requiring special care 10% require care within either a skilled-care or other long-term care facility 15% die shortly after the stroke...
View Full Document

This document was uploaded on 02/03/2014.

Ask a homework question - tutors are online