Neuro CH 3

Etiologies of neurogenic communication disorders include:

stroke, TBI, Surgical trauma, degenerative disorders, infectious diseases.

Define Idiopathic Etiology

unknown cause

A stroke is also known as a

cerebrovascular accident (CVA)

A stroke causes death in more _____________.

women

Factors that increase likelihood of stroke:

Tobacco use, physical inactivity, atrial fibrillation, high blood pressure

Anoxia

complete lack of oxygen

Hypoxia

partial lack of oxygen

The brain consumes ______% of oxygen taken in by the body and can survive _______ minutes without oxygen.

20, 6-8

What happens to brain tissue when it dies?

reabsorbed by the body

Majority of strokes are

ischemic

What does BEFAST stand for?

Balance

Eyes

Face

Arms

Speech

Time

The part of the brain that is deprived of blood flow dies within:

1 hour

What is the stroke "golden hour"

critical 1-3 hour window that begins the last moment the patient was normal.

Medication known as a "clot buster"

rT-PA

T-PA works by:

thinning the blood

What type of strokes can you not use TPA?

hemorrhagic

What would make a patient not a candidate for t-pa?

waking up with a stroke

after the first hour, the benefits of tpa decrease over....

the next two hours.

what type of stroke is a dry stroke?

Ischemic

What causes an ischemic stroke?

blockage of a blood vessel

In an ischemic stroke what is the "Area of Infarct"?

focal point of stroke

the death of brain cells in and around the infarct causes tissue _________ and is ______________.

necrosis, irreversible.

Gliosis is the process of the dead tissue _______, ____________, and is ____________ by the brain.

softening, liquifies, absorbed.

In gliosis which neuroglia cleans out and removes the dead tissue?

microglia

What is a lesion in ischemic stroke?

crater left in the place of the healthy tissue.

Ischemic Penumbra

area surrounding the ischemic core

The ischemic penumbra experiences too much blood loss to ____________ but enough to _________ __________.

funciton, stay alive.

Penumbra are supplied with blood from ________________ arteries.

surrounding

Damage to penumbra can be reversed within _________ hours of medical attention.

2-4

What are the three types of ischemic strokes?

thrombotic, embolic, transient ischemic attack

Transient Ischemic Attack is also known as a:

mini stroke

Cause of an Transient Ischemic Attack

small ischemia in the brain.

Transient Ischemic Attacks typically resolve within _____ ______.

24 hours.

Symptoms of a Transient Ischemic Attack

Mild motor and cognitive deficits that go away after the blood clot is resolved

do Transient Ischemic Attacks cause permanent deficits?

No, unless they are recurring.

Cause of a thrombotic stroke:

thrombus forms and interrupts blood flow within the brain.

Thrombus are usually due to __________________.

atherosclerosis

What is Atherosclerosis

The build-up of fats, cholesterol, and other substances in and on the artery walls.

How does Atherosclerosis impact vessels?

Narrows passage for blood to flow and makes vessel more brittle less flexible.

How does a thrombus become an embolus?

a piece breaks off, travels, and lodges within a vessel to interrupt circulation.

What is an embolus?

a mass traveling through the circulatory system

Cause of an Embolic stroke

Embolus lodges within a blood vessel inside the brain which cuts of circulation to a part of the brain.

Hemorrhagic Stroke occurs when:

Blood vessel ruptures, blood spills into brain, and deprives a part of the brain of blood flow.

Hemorrhagic Strokes typically occur in people who:

- have Hypertension

- Engage in high periods of physical activity

- history of hem-strokes

- alcohol abuse

- born with predispositions for aneurysms.

Congenital Factors of Hemorrhagic Stroke:

AVM and Aneurysms

AVM

Arterial Venous Malformation

What is AVM

Capillary system that normally acts as a buffer for high pressure arterial flow into low pressure venous flow is missing.

How does AVM impact fragile venous tissue?

makes it more susceptible to rupture due to high pressure.

What is an Aneurysm?

Abnormal stretching or ballooning out of the wall of a blood vessel.

An aneurysm can result from:

disease, hereditary factors, hypertension, atherosclerosis.

Aneurysms usually occur in the:

Circle of Willis

Onset of hemorrhagic stroke are _________.

sudden

Symptoms of Hemorrhagic Stroke

Severe headache, nausea, and vomiting

First mechanism of damage that may occur with Hemorrhagic Stroke

Blood supply to a portion of the brain is interrupted due to a burst/broken blood vessel.

Second mechanism of damage that may occur with Hemorrhagic Stroke

Blood spilling out into the brain tissue where it does not belong causes damage.

Third mechanism of damage that may occur with Hemorrhagic Stroke

Intracranial pressure increases due to the continued release of blood into the brain.

What is a hematoma?

bleeding that has clotted to some extent.

What is a hemorrhage?

active/ongoing bleeding.

Epidural Hemotoma

a hematoma located outside the dura mater

Subdural Hematoma

in between arachnoid mater and dura mater

subarachnoid hemorrhage

Bleeding into the subarachnoid space above the pia mater

intracerebral hemorrhage

Bleeding under the pia mater or within brain tissue.

Main two ways to prevent a stroke

diet, nutrition, maintaining healthy weight.

Traumatic Brain Injury

brain damage resulting from an external and forceful event.

Common causes of TBI

Falls, motor vehicle accidents (MVA), violent assault, being struck by an object

Immediate impact of TBI ranges from:

mild concussion - coma- death

Language and Cognitive deficits as a result of TBI depend on:

what areas of the brain are damaged and to what extent.

TBi is common for children ages ___ years and under.

4

Secondary Brain Injury

The delayed injury following a primary injury

Hypoxic Brain Injury is an under reported consequence of:

overdose and oversedation

Hypoxic Brain injury is due to:

lack of oxygen to the brain

Additive properties of Drugs: (2)

Desensitization and Long-term drug seeking behaviors.

Opioid-related Brain Injuries: (2)

Anoxic/Hypoxic Injury, Toxic Brain injury.

Anoxic/Hypoxic Brain Injury severity depends on extent and length of ____________ ________________.

oxygen deprivation

Anoxic/Hypoxic Brain Injury damage is usually ___________.

diffuse

Toxic Brain Injury is damage to the brain induced by:

high levels of toxins in the body

Toxic Brain Injury is common in _________ abuse and ______ Poisoning.

Opioid, CO1

"Wet Brain" is also called:

Wernicke Korsakoff Syndrome

"wet brain" develops from repeated:

heavy drinking

"Wet Brain" occurs in two stages, the first stage is called:

Wernicke's Encephalopathy

Wernicke's Encephalopathy makes biochemical ____________ of the nervous system due to lack of vitamin ________.

lesions, B1

Wernicke's Encephalopathy causes impaired ____________ coordination, confused ________ state, and paralysis of the nerves that control ________ ______________.

muscle, mental, eye movement

If Wernicke's Encephalopathy is treated with _____________, symptoms may be reversed.

thiamine

The second stage of Wernicke Korsakoff Syndrome is called:

Korsakoff's Psychosis

can damage from Korsakoff's Psychosis be reversed?

No, it's permanent (recovery with treatment is unlikely).

Where is the damage from Korsakoff Psychosis?

Memory portion of the brain.

Korsakoff Psychosis leads to severe ___________ loss and difficulty making new ones as well as ___________ and ___________ hallucinations.

Memory, visual, auditory

Biopsy is a:

surgery to remove a piece of tissue for testing

Malignant brain tumors are ______________.

cancerous

Malignant Brain Tumors can grow and _________ quickly to other body parts.

spread

Malignant Brain Tumors can be treated with: (2)

Surgical Removal and Radiation

Benign Brain Tumors cannot _________.

spread

__________ effect may occur with Benign Brain Tumors

mass

Benign Brain Tumors are problematic due to ______________.

Pressure

Define Neoplasm

Abnormal growth of cells in the brain

Neoplasm serves no ___________ to the body.

purpose

Names of neoplasm are based on:

The types of cells they are composed of

Name the three types of Neoplasm:

Astocytoma, Oligodendroglioma, and Mixed

Asyocytoma grows from

Astrocytes

Astocytoma are ________ ________.

Glial Scar