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Cerebral Ischemia

Ch 17 Clinical Notes

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
Created by: 1190550002
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