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Anterior Cerebral Artery (ACA)
branches off the internal carotid artery and supplies the frontal and parietal lobes
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ACA Occlusion site for CVA
- Usually presens w/ greater involvement of the LE than UE or face
- Extensive frontal lobe infarction produces significat behavioral changes
- Right-sided damage to the frontal lobe may cause contralateral neglect
- Damage to the supplementary motor area may produce aphasia
- Lesions of the ACA are uncommon
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Middle Cerebral Artery (MCA)
branches off th internal carotid artery and supplies the lateral aspect of the cerebral hemispher(frontal, temporal and parietal lobes)
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MCA Occlusion site for CVA
- Most common site of stroke
- Occlusion results in drowsiness, contralateral hemiplegia, and cortical sensory loss of the face, arm, and leg w/ the face and arm more involved than the leg
- Homonymous hemianopsia (visual field defect) and deviation of the eyes away form hemiplegic side also result
- Broca's aphasia (expressive dysfunction ) results from occlusion of the MCA affection the lwoer frontal cortex.
- Wernicke's Aphasia (recpetive dysfunction) may also result from temporal lesions
- Pts exhibiting global aphasia (involves both Broaca's and Wernicke's areas) have severe expressive and receptive language dysfunction.
- Apraxia, a disorder of voluntary learned movement, is also common.
- Infarction of the non-dominant right hemisphere typically produces a flat or expressionless affect
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Posterior Cerebral Artery (PCA)
arises fdorm the basilar artery, and supplies the corresponding occipital, medial and inferior temporal lobe.
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PCA Occlusion site for CVA
- Occlusion of thalamic branches (affecting pain and temperature the most) and persistent contralateral pain in respose to any type of sensory input.
- Proprioception is severly involved.
- Right-sided infarcts produce hemianopsia, and left-side infarcts produce alexia (word blindness) and anomia (word-finding difficulty).
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During the early stages of stroke
- flaccidity w/ no voluntary movement is common.
- Flaccidity is usually present immediately after the stroek and is generally short-lived, lasting hours, days or weeks.
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flaccidity is usually replaced by
development of spasticity and mass patters of movement, termed synergy's
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Spasticity emerges in about ___ of cases.
90%
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Muscles involved in synergy patterns are often
so strongly linked together that isolate dmovments outside the mass movment patterns are not possible
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As recovery progresses...
spasticity begin to declien and advanced movement pattersn become possible
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