| Term | Definition |
| Static Brain Imaging | -imaging that allows the identification brain structures (
-i.e. CT |
| Dynamic | -Identify function of brain
-PET or fMRI |
| Cerebral Angiography | -Identifies arterial disease, aneurysms and AV malformations
-Radiopaque substance released into bloodstream and followed through system |
| CT | -Imaging technique that relies on X-rays
-Widely available
-Most (if not all) hospitals and many clinics also have them because of relatively low cost
-Shows body structures (bone and soft tissue) – does not show function (metabolism) |
| What is CT used for? | -Mainly used for bone scans, chest x-rays, and stroke imaging
-Takes 1-5 mins & is optimal for detection of cerebral hemorrhage
-Usually does not detect acute ischemic stroke
-Patients who receive tPA always get CT before to rule out hemorrhage |
| Advantages of CT | -Very quick compared to other imaging techniques
-Gives good spatial resolution compared to metabolic imaging (PET)
-New CT applications can scan perfusion
-Is widely available
-Cheap compared to MRI. CT 100-200k, MRI 3mil |
| Disadvantages of CT | -Uses X-rays (radiation!)
-Cannot detect acute ischemic stroke
-Poor spatial resolution compared to MRI
-Good for ruling out a hemorrhage, but not good for detecting an acute systemic stroke |
| How to read a CT Scan | -Right is right and left is left (NOT flipped)
-Ischemic stroke: Dark
-Bleed: Bright
-Tumor: Dark
-MS Plaque: Dark |
| Magnetic Resonance Imaging | -Not radiographic, analyzes response to radiofrequency signal
-Visualizes structures
-Does use radiation so no increase cancer risk |
| How to read MRI | -right is left and left is right
-T1-MRI: ischemia/infarct- dark, bleed- bright, tumor - dark, MS plaque- dark
-T2-MRI: ischemia/infarct- bright, bleed- bright(hard to see), tumor - bright, MS plaque- bright |
| Positron Emission Tomography (PET) | -Measures glucose tagged with radioactive substances to determine which tissues have highest energy use during activity
-Doesn't emit radio activity, but measures what you inject into person (or person drinks). |
| What is PET used for? | -Mostly used in cardiac and cancer management
-Can distinguish b/w Alzheimer's, blood flow shortages, depression, or other reason for dementia
-Can localize site of seizures
Can detect: Small tumors, Viable cardiac tissue, Decreased brain metabolism |
| PET Disadvanatges | Takes a long time. Therefore:
-Not optimal for persons with acute condition needing immediate medical management
-Not for persons who have difficulty laying still for extended period of time |
| fMRI | -Person lies in scanner & completes a specific task
-Used to determine which parts of the brain are activated by different types of physical sensation or activity, such as: Sight, Sound, Language, Finger tapping |
| Electroenceph- alography (EEG) | -Measuring electrical potentials from electrodes placed on the scalp
-Can make comparisons of activity in various parts of the brain
-Creates Topographical mapping of brain’s electrical potentials
-Compares diff wave patterns and function over time |
| Electro- myography | -Measure electrical activity at the level of the muscle
-Can determine if muscle is receiving electrical stimulation
-Helpful in spinal injury cases and myoneural problems |
| Dichotic Listening | -Assesses cerebral dominance for language
-speech understood better with right ear as fibers cross to left hemisphere which is dominant for speech
-Two words presented simultaneously - one to each ear - Person reports which word was processed |
| Lumbar Puncture | -aka Spinal Tap to determine the presence of infections in cerebrospinal fluid
-Fluid removed from lumbar subarachnoid space and is subjected to lab test to look for blood or infections |
| Cortical mapping through craniotomy | -Done before craniotomy surgery to prevent cutting into language, memory or motor function.
-Can also be done through TMS (trans magnetic stimulation) |
| Stereotactic Surgery | -subcortical mapping
-Done when surgeon wanst to put a lesion in sub cortical areas (i.e. basil ganglia) to try to reduce abnormal movement. |
| Carotid Endarterectomy | -Removal of sclerotic plaque from the common carotid artery to increase blood flow |
| Aneurysm Clipping | -Metal clip is used to obliterate the bulge to reduce possibility of rupture
-Can also do embolizing by using a catharater with metal at end to get platelets to block blood from coming into aneurysm area. |
| Seizures | -Instability of electrical activity in the brain
-70-75% occur before age 20.
-Some are not recurrent
-Can be 2nddary to head injury, metabolic abnormalities, tumors, infarcts, infections, and physiological disturbances. |
| Partial-Focal seizures | -Type of seizure
-Single area with a cortical or subcortical lesion
-Seizure spreads from one body part action recruiting additional movement (could maybe start in leg than spread upwards) |
| Partial-Complex Seizures | -Lesions in temporal lobe structures
-Automatic irrational behavior for which there is not memory
-Can lead to interruptions in language. |
| Petit Mal Seizures | -Between ages 3 and 12 usually disappear after age 30
-Staring, chewing clinking, and myoclonic jerks, extenstion of extremities |
| Grand Mal (Tonic Clonic) Seizures | -Loss of consciousness with tonic convulsion |
| What to Do When a Person Has a Seizure? | -Do not hold the person down or try to stop movements
-Keep objects away from area to prevent injury
-Do not put anything in the mouth
-Turn head to side to avoid choking on food
Call for assistance and observe symptoms. Time the seizure if possible |
| What is a stroke | -occurs when normal blood flow to the area of a brain is cut off. When blood flow is cut off neurons begin to die. |
| Right Hemisphere strokes can cause | -Left side paralysis
-Left side loss of vision
-Neglect
-Left side body sensation loss |
| Left Hemisphere strokes can cause | -Right side body paralysis
-Inability to speak or understand speech
-Right side vision loss
-Right side body sensation loss |
| Brain Stem & Cerebellum strokes can cause: | -Difficulty swallowing
-Double vision
-Slurred speech
-Loss of balance or dizziness
-Paralysis
-Unstable blood pressure
-Impaired breathing
-Coma |
| Amount of stroke survivors that suffer a 2nd stroke | -About 1/4 of stroke survivors have 2nd strokes. |
| Heart attacks and stroke | -Small percentage of stroke victims suffer heart attacks or irregular heart beats after stroke. |
| Dysphagia & aspiration Pneumonia | -some stroke victims have difficulty chewing and swallowing which causes food and liquids to go to lungs instead of stomach. Proper positioning and diet used to prevent this. |
| Cerebral Edema | Swelling of the brain. Time best healer. Meds only used in severe cases. |
| Pulmonary Embolism | -Blood clots forming in legs or pelvis may travel to lungs and get lodged there. Can lead to lung or heart damage and even death.
-To prevent this complication meds maybe prescribed to reduce chances of blood clots forming. |
| Urinary Tract Complications | -Stroke survivors may have trouble with kidney and bladder functions due to dehydration, side effects to meds, loss of bladder sensation, or infection. |
| Percentage of stroke victims that suffer from depression | -occurs in 50% of stroke victims.
-Families also experience emotional stress. |
| Recovery and Rehab after stroke | -Rehab starts within 2 days of stroke.
-Some areas of brain that were injured may resume function.
-Other areas may compensate for injured areas. -Brain maybe able to reorganize it’s own functioning. |
| Recovery percentages | -15% of people die shortly after the stoke
-10% recover almost completely
-25% recover with mild impairments
-40% experience moderate to severe disabilities
-10% need long term facility care.
-There are 3 mil stroke survivors alive today in US |
| What happens to stroke survivors after hospital | -go to a rehab unit in or out of hospital
-Can go home with care
-Go to a long term care facility
-Everyone in family must take up new roles. Join a support group. Schedule breaks in care giving
-includes physical, occupational and speech therapy. |
| Goal of rehab is to... | -make person as independent as possible- |
| Ho can family help a family member who's suffered a stroke? | -Family can help by encouraging, supporting and giving love and allowing survivor to do things themselves. |
| Stroke stats in US | -3rd leading cause of death (behind heart disease and cancer)
-leading cause of adult disability, impact 1 out 5 families in US.
-Cost $25 billion each year |
| Transit Ischemic Attack | -temporary loss of blood flow to the brain.
-Symptoms can include:
-sudden inability to speak,
-difficulty understanding speech, sudden
weakness or numbness of arm or hand.
-dizzy or black out.
-most TIA patients will have a stroke |
| Preventing stroke | -Exercising
-Diet change
-Loose weight
-Reduce blood pressure
-Reduce cholesterol
-Stop smoking
-Drink alcohol only occasionally |
| Stroke warning signs | -Sudden impaired vision
-Numbness, weakness or paralysis
-Trouble speaking or understanding
-Difficulty swallowing
-Dizziness
-loss of balance or unexplained fall |
