Stroke

Question 1

brainstem

Answer 1

important functions

• Heart rate
• breathing
• consciousness
• ANS

Question 2

cerebellum

Answer 2

controls and coordinates balance and fine muscle movement

Question 3

frontal lobe

Answer 3

• motor cortex
• judgement
• inhibition
• personality
• emotions

Question 4

Parietal lobe

Answer 4

• sensory processing

- orientation

Question 5

occipital lobe

Answer 5

vision

Question 6

temporal lobe

Answer 6

• arbitrary perception

- memory formation (LTM - face recognition)

Question 7

what is a stroke?

Answer 7

interruption of blood supply to the brain

interruption can cause cell death to areas no longer receiving oxygen and glucose
- can affect different areas in the brain

Question 8

ischemic stroke

Answer 8

blockage that DISRUPTS blood flow to the brain (most common)

• different types:

> cerebral thrombosis
cerebral embolism
systemic hypoperfusion

Question 9

cerebral thrombosis

Answer 9

• blood clot in major artery of the brain
• area affected called an infarction (dead cells)
• ‘thrombotic stroke’

Question 10

cerebral embolism

Answer 10

• blood clot in different area of the body but travels up to the brain
• usually linked to atherosclerosis (build up of plaque - fatty materials, scar tissue or calcium) - blood clots form where plaques rupture
• clot area = donor site
• where it affects = recipient site
• ‘embolic stroke’

Question 11

systemic hypoperfusion

Answer 11

• general reduction in blood flow to the brain caused by issues with the heart (cardiac output)

Question 12

haemorrhagic stroke

Answer 12

• less common, more severe
• brain can swell until it presses against skull
• damage to a blood vessel that bursts (lack of oxygen and nutrients)
• can occur from an artery bursting deep within the brain (epidermal)
• can occur from bleeding at the surface of the brain
  (subarachnoid)
  common defects include aneurysms (weak areas in blood vessel wall that balloon and burst under pressure and malformations of blood vessels from birth)
• different types:

> intracerebral haemorrhage
subarachnoid haemorrhage
- epidural haemorrhage and subdural haemorrhage

Question 13

intracerebral haemorrhage

Answer 13

• blood vessel damage deep inside the brain

Question 14

subarachnoid haemorrhage and epidural haemorrhage

Answer 14

• blood vessel bursts in subarachnoid space (between skull and brain)
• subarachnoid haemorrhage = blood filling the space in between the skull and brain
• epidermal haemorrhage = bleed in one area of subarachnoid space that extends into the brain

Question 15

transient ischemic attack

Answer 15

• temporary loss of blood supply to the brain
• blood clot dissolves itself
• symptoms < 24h
• often happen before more severe strokes

Question 16

Areas of damage (AoD)

Answer 16

• cerebrum (left and right hemisphere)
• motor cortex or primary somatosensory cortex
• brain stem
• Wernicke’s area (40% of people develop language problems after stroke)
• Brocca’s area
• occipital lobe
• cerebellum
• sudden severe headache

Question 17

AoD

cerebrum (right hemisphere)

Answer 17

• weakness/paralysis (left side of body)
• cognitive problems (reading, talking, thinking, learning, remembering new information)

(in general - less common but can cause issues with orientation and balance)

Question 18

AoD

cerebrum (left hemisphere)

Answer 18

• weakness/paralysis (right side of body, ignore things on left side of body [contralateral neglect])
• vision
• depth perception
• ST memory loss
• judgement

(in general - less common but can cause issues with orientation and balance)

Question 19

AoD

Brain stem

Answer 19

• not very common
• affects core functions (breathing, heart function, swallowing)
• usually beyond recovery

Question 20

AoD

Motor cortex or Primary somatosensory cortex

Answer 20

• numbness in face/arm/leg (somatosensory cortex - key for feeling e.g. change in sensation when damaged)
• weakness in face/leg/arm (motor cortex - controls bodies movement)
• affects contralateral side

Question 21

AoD

Wernicke’s area

Answer 21

• junction of temporal and parietal lobe
• understanding what people are saying
• also used to produce specific meaningful speech

= poor comprehension and use of words to express what you actually mean

Question 22

AoD

Brocca’s area

Answer 22

• frontal lobe
• fluid speech production

= slow and poorly structures speech

Question 23

AoD

Occipital lobe

Answer 23

• vision loss

- contralateral damage

Question 24

AoD

cerebellum

Answer 24

• sudden dizziness or loss of balance and coordination
• damage to cerebellum or blockage in 3 main arteries that feed cerebellum
• major coordinator of movement
• less common than cerebrum

= uncoordinated and lack of precision in movement, dizziness, headaches, nausea, vomiting

Question 25

AoD | bursting blood vessel in the brain

Answer 25

- sudden severe headache with no known cause | - common in a haemorrhagic stroke

Question 26

blood supply in the brain

Answer 26

- brain contains specialised cells (glial cells) - blood supply in brain is broken down into anterior blood vessels (front) and posterior blood vessels (back) - arteries come together to form the circle of willis - different arteries supply different areas

Question 27

how much oxygen and cardiac output does the brain use?

Answer 27

- brain uses 20% of oxygen and 15% of cardiac output

Question 28

how is blood supply in the brain broken down?

Answer 28

- blood supply in brain is broken down into anterior blood vessels (front) and posterior blood vessels (back)

Question 29

what do the arteries in the brain form?

Answer 29

circle of willis - contains important blood vessels that feed the brain including middle cerebral artery