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5 responsibilities of L side of brain
- language & speach
- motor dominance (probably flips to R side in lefties)
- writing
- verbal memory
- R-L distinctions
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5 responsibilies of R side o brain
- non-verbal visual comprehension
- music
- attenion span/focus
- emotion - behavior & intellectual defecits
- figure ground deficits (understanding depth perception)
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in addition to the normal motor and sensory problems of stroke, a stroke in the L hemisphere can also lead to _, _, _, and _.
- apraxia (motor sequencing problems)
- alexia (difficulty reading)
- R-L discrim problems
- slow in organization and performance
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in addition to the normal motor and sensory problems of stroke, a stroke in the R hemisphere can also lead to _, _, _, _, _, _, and _.
- visual-spatial defects
- distorted body image (may not know one limb is theirs)
- unilateral neglect
- time orientation (shows up late or early)
- spatial concepts
- impulsive
- dressing apraxia
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ischemic CVAs make up what percent of all CVAs? what kinds of ischemic do we have?
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predisposing factors for a thrombus CVA
- hypertension
- diabete
- high cholesterol
- smoking
- alcoholabus
- atril fibrilation
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the onset, the trouble,and the tx for thrombotic CVAs
- onset: abrupt - minutes to a few hours
- deficit: at location of thrombus and in collateral circ
- tx: IV heparin, oral coumadin
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TIAs - clear how fast? precede _% of all strokes, w/i 5 years _% chance of having a CVA?
- clears within 24 h
- precedes 10% of all strokes
- within 5 years, 33% chance of a CVA
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symptoms of a TIA
- heiparesis
- hemisensory disturbances
- transient aphasia
- facial weakness &/or numbness
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treatment of TIA
- dtermine etiology & intervene
- endarectomy (clean out an artery)
- aspirin therapy (as a precaution, but not if it's hemorrhagic)
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embolic stroke - onset, and most common site of lodging
- onset is rapid in < a minute
- middle cerebral artery
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etiology of embolic stroke
- cardiac (atrial fib) - bc blood's not flowing right pt can form a clot
- myocardial infarction throwing a clot
- valve defects
- endocarditis
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a big worry about embolic strokes
33% become hemoragic over the next 3-4 days due to necrosis of the vessel secondary to the infarct
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tx for embolic stroke
- best to just do prevention
- no anticoagulants after due to possibility of hemorrhage
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hemorrhagic stroke - % of all strokes, locations
- highest mortality rate -- it's uncontrolled bleeding into cranium
- 15-20% of all strokes
- 70% in internoal capusle
- 20% in brainstem or cerebellum
- the rest are elsewhere
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most common cuse of intracerebral hemorrhae?
HTN - 66% die from initial bleed
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4 types of hemorrhagic CVAs
- intracerebral hemorrhage
- ruptured aneurysm (small, berry-shaped dilation of an artery)
- artreriovenous malformation (AVM)
- trauma/TBI - not exactly a stroke but same ballpark
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arterioveous malformation
AVM = congenital abnormality of a mass of thin wall dilated small vessles fed by large arteries - typically asymptomatic til there's rupture or progressive neurological deficit due to gradual enlargement
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