Neurology: Cerebrovascular Accident

Vocabulary flashcards for Neurology: Cerebrovascular Accident lecture notes.

Cerebrovascular Disorder

Sudden loss of neurological function due to hypoxia.

Transient Ischemic Attack (TIA)

Temporary loss of neurological function due to loss of blood supply, typically less than 24 hours, with no infarction in cranial imaging.

Reversible Ischemic Neurological Deficit (RIND)

Loss of neurological function typically lasting more than 24 hours but not greater than 21 days, often due to subsiding brain edema.

Stroke in Evolution

Progressive neurological deficit right after admission to the hospital.

Complete Stroke

Stroke where no further deterioration is evident.

Non-Modifiable Risk Factors for Stroke

Age, Gender, Race, Family history, History of previous stroke.

Modifiable Risk Factors for Stroke

HTN, Heart disease, Diabetes mellitus, Smoking, Sedentary lifestyle, Metabolic disease, Obesity, Personality and behavior.

Ischemic Stroke

Stroke caused by a blockage, accounting for 80% of stroke cases.

Hemorrhagic Stroke

Stroke caused by bleeding in the brain, accounting for 20% of stroke cases.

Thrombotic Stroke

Ischemic stroke usually caused by atherosclerosis leading to narrowing of blood vessels.

Embolic Stroke

Ischemic stroke usually caused by a cardiac embolism.

Lacunar Stroke

Ischemic stroke involving small, circumscribed lesions in deep perforating branches.

Intracerebral Hemorrhage

Hemorrhagic stroke often caused by long-duration HTN leading to pseudoaneurysm.

Subarachnoid Hemorrhage

Hemorrhagic stroke that can be caused by saccular aneurysm or arteriovenous malformation.

Amaurosis Fugax

Transient monocular blindness

Paratonia (Gegenhalten syndrome)

Force dependent resistance to passive movement.

Abulia (Akinetic mutism)

Lack of motivation or initiative

Internal Carotid Artery (ICA) Stroke Syndrome

Stroke syndrome with symptoms similar to MCA stroke, but can include amaurosis fugax and aphasia.

Anterior Cerebral Artery (ACA) Stroke Syndrome

Stroke syndrome often asymptomatic, but can cause C/L hemiplegia and hemianesthesia (worse in LE), paratonia, abulia, disconnection apraxia, and urinary incontinence.

Medial Cerebral Artery (MCA) Stroke Syndrome

Stroke syndrome causing C/L hemiplegia and hemianesthesia (worse in UE and face), C/L homonymous hemianopsia, dysphagia, and aphasia.

Posterior Cerebral Artery (PCA) Syndrome

Stroke syndrome causing C/L homonymous hemianopia with macular sparing, memory impairment, thalamic pain syndrome, and Weber syndrome.

Vertebrobasilar Artery Stroke Syndrome (VBA)

Stroke syndrome with general clinical features including loss of consciousness, quadriplegia, CN abnormalities, and cerebellar manifestations.

Weber Syndrome

Brainstem stroke; Lesion: medial basal midbrain; Manifestations: I/L CN 3 palsy, C/L hemiplegia

Benedikt Syndrome

Brainstem stroke; Lesion: tegmentum of the midbrain; Manifestations: I/L CN 3 palsy, C/L loss of pain and temperature at the body, C/L apraxia, C/L loss of proprioception, C/L chorea

Locked-in Syndrome

Brainstem stroke; Lesion: bilateral basal pons; Manifestations: Quadriplegia with spared upward gaze

Millard-Gubler Syndrome

Brainstem stroke; Lesion: lateral pons; Manifestations: I/L CN 6 and 7 palsy, C/L hemiplegia

Wallenberg Syndrome

Brainstem stroke; Lesion: lateral medulla; Manifestations: I/L loss of pain in the face and C/L loss of pain and temperature in the body (Crossed hemianesthesia), Horner’s syndrome, Nystagmus

Anterior Inferior Cerebral Artery Stroke Syndrome (AICA)

Brainstem stroke; Affected structures: CN 5, 6, 7 and 8, Spinothalamic trunk, Cerebellum; Manifestations: Crossed hemianesthesia, Horner syndrome

Superior Cerebral Artery Syndrome

Brainstem stroke; Affected structures: CN 3 and 4, Spinothalamic trunk, Cerebellum; Manifestations: C/L loss of pain and temperature in the body, Horner syndrome

Pure Motor Stroke

Lacunar stroke lesion: posterior limb of internal capsule

Pure Sensory Stroke

Lacunar stroke lesion: thalamus

Sensorimotor Stroke

Lacunar stroke lesion: junction of internal capsule and thalamus

Dysarthria Clumsy Hand Syndrome

Lacunar stroke lesion: anterior limb of internal capsule

Ataxic Hemiparesis

Lacunar stroke lesions: Pons, Internal capsule, Cerebellum, Corona radiata

Chorea

Involuntary movement; Lesion: neostriatum; rapid, jerky, irregular movements; Affected proximal limb, face, and trunk

Dystonia

Involuntary movement; persistent contraction of agonist and antagonist muscles

Athetosis

Involuntary movement; Lesion: globus pallidus; slow-writhing, worm-like, slow and fluid movements; Affected distal limb

Hemiballismus

Involuntary movement; Lesion: subthalamic nucleus of Luys; wild and flailing movements

Spasticity

Velocity-dependent resistance to passive movement

Anomic Aphasia

Language problem: (+) Repetition, (+) Comprehension, (+) Fluency, (-) Name

Conduction Aphasia

Language problem: (-) Repetition

Transcortical Sensory Aphasia

Language problem: (+) Repetition, (-) Comprehension

Wernicke’s Aphasia

Language problem: (-) Repetition, (-) Comprehension

Transcortical Motor Aphasia

Language problem: (+) Repetition, (+) Comprehension, (-) Fluency

Broca’s Aphasia

Language problem: (-) Repetition, (-) Comprehension, (-) Fluency

Global Aphasia

Language problem: (+) Repetition, (-) Fluency

Frontal Gaze Palsy

Visual Changes: Happens in patients with hemispheric lesion; Patients looks towards the lesion and away from the hemiplegic side

Pontine Gaze Palsy

Visual Changes: happens in patients with brainstem lesion; Patients looks towards the hemiplegic side and away from the lesion

Apraxia

Inability to carry out certain movements in response to stimuli that normally elicit these movements

Ideational Apraxia

(-) automatic and command; Lesion: corpus callosum or L dominant parietal lobe

Ideomotor Apraxia

(-) command, (+) automatic; Lesion: supramarginal gyrus or B.A. 40

Agnosia

Failure to recognize stimuli even with intact sensory systems

Visual Agnosia

MC type; Lesion: B.A. 18 & 19

Auditory Agnosia

Lesion: R B.A. 22

Tactile Agnosia

Lesion: R B.A. 40

Associated Reaction (Huntington Reflex)

Abnormal Reflexes:↑'d UE flexion synergy 2° yawning, sneezing, or coughing

Homolateral Limb Synkinesis

Abnormal Reflexes: Movement of UE → movement of I/L LE

Raimiste's Phenomenon

Abnormal Reflexes: Abduction of normal limb → abduction of hemiplegic side

Sterling’s Phenomenon

Abnormal Reflexes: Abduction of normal limb → abduction of hemiplegic side

Souques Phenomenon

Abnormal Reflexes: arm elevation → finger extension

Listing Phenomenon

Abnormal Reflexes: strong side pushes the weak side, which leads to ↑'d risk of fall

Anosognosia

Denial of paralysis

Somatognosia

Inability to identify body parts

Finger Agnosia

Inability to identity fingers

Figure-ground discrimination

Visuospatial Deficit: Cannot distinguish item from background

Form discrimination

Visuospatial Deficit: Cannot identify form of object

Position in space

Visuospatial Deficit: Cannot identify position in space

Vertical disorientation

Visuospatial Deficit: Impaired sense of verticality

Topographical disorientation

Visuospatial Deficit: Impaired sense of geometric and topographic structure