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Cerebral Ischemia
Ch 17 Clinical Notes
| Question | Answer |
|---|---|
| Contralateral hemiparesis/hemisensory loss involving mainly leg & foot | ACA occlusion (paracentral lobule) |
| Inability to identify objects correctly; due to connections thru parietal lobe | ACA occlusion |
| Apathy & personality changes (frontal lobe); patient may not recognize personality change, but those who know them will see a change. | ACA occlusion |
| Anterior limb of IC loses blood supply | ACA occlusion |
| Contralateral hemiparesis/hemisensory loss in mostly face, arm & trunk | MCA Occlusion |
| Various aphasias if left side affected | MCA occlusion |
| Anosognosia is right side affected (this is a form of sensory neglect) | MCA occlusion |
| Various field cuts- damage to optic radiation | MCA occlusion |
| Genu/posterior limb of IC blood supply | MCA occlusion |
| Visual field cuts | PCA occlusion |
| Contralateral homonymous hemianopsia with some degree of macular sparing | PCA occlusion |
| Visual agnosia- ischemia of left occipital lobe & visual assn. areas | PCA occlusion |
| Memory impairment (medial temporal lobe affected) | PCA occlusion |
| Trouble giving correct response when receiving multiple inputs (speech, hearing, vision, etc. at same time) | PCA occlusion |
| Same as MCA occlusion; + partial or complete loss of sight on ipsilateral side | Internal Carotid occlusion |
| rarely severe enough to damage brain, but BP is affected | Postural Hypotension |
| after trauma or when cerebral aa. already compromised; hyperventilation may reduce cerebral blood flow by lowering CO2 content | Physical/Physiological Shock |
| Change in blood viscosity | thicker blood, so speed is decreased |
| Condition where cerebral blood flow is considerably reduced b/c of increased blood viscosity | Polycythemia vera |
| Distention of carotid arterial wall causes reflex slowing HR & fall in BP; external pressure on carotid sinus may cause LOC | Carotid Sinus Syndrome |
| CV conditions causing severe fall in general arterial pressure & reduction in cerebral blood flow | Heart Disease |
| Disease may affect main arteries supplying brain in their course thru neck & skull; doesn't happen in all vessels & not to an equal extent in any vessel; build-up of plaque | Atheroma |
| Common with diabetes/HTN; long term narrowing without actural blockage of narrowed area by thrombus can lead to problems | Atherosclerosis |
| Disease made worse by: coronary conditions with its associated hypotension; shock due to surgery/trauma; severe anemia; rotation of head with external pressure on carotid aa. | Atherosclerosis |
| Embolism due to thrombus (plaques breaking off); Fat globules (fx of long bones) | Blockage of arterial lumen |
| Leakage or rupture of congenital aneurysm on COW or from angioma or contusion/laceration of brain/meninges | Subarachnoid ICH |
| S/sx of subarachnoid hemorrhage | Severe headache; stiff neck; LOC |
| Rupture of atheromatous a.; common with HTN; BAD; often involves lenticulostriate aa (s/sx contralateral); hemorrhage into ventricle (s/sx bilateral; ventricles interconnected so bilateral problems when blood gets in one) | Cerebral ICH |
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1190550002
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