Types of aphasia
Broca's
Non-fluent, good comprehension, poor repetition
Lesion= Broca's area, and posterior inferior frontal gyrus in left hemisphere
Writing problems, poor reading, anomia, agrammatism
Conduction
Fluent, good with comprehension, difficulty repeating
Lesion=arcuate fasciculas, disconnect between Wernicke's and Broca's
Anomia that can disrupt the flow of words, paraphasias (literal/phonemic), self-correction, difficulty with repetition is primary impairment, with writing their are spelling errors, words transposed and poor writing to dictation, can read silently but has oral reading deficits
What are the 2 types of CVA's and describe each of them
Ischemic (infarction/occlusive stroke)- caused by a blockage of blood flow to the brain due to a clot or embolus (better chance of survival)
Hemorrhagic- caused by the rupture of a vessel or aneurysm resulting in the blood flow out of the vessel and into the surrounding brain tissue, results in increased intracranial pressure (increased likelihood of death)
An injury to the brain produced by external forces that may cause temporary or permanent physical, cognitive, emotional or behavioral impairments is called what?
Results in diffuse injury to brain
TBI
Which type of dementia is a degenerative neuro-motor disorder that results from a loss of brain cells from the substantia nigra which are responsible for producing dopamine.
Parkinson's Disease
Transcortical Motor
Non-fluent, good comprehension, good at repeating
Lesion=
Anterior Frontal paramedian, anterior and superior to Broca’s areas
impaired initiation, writing problems, anomia, short phrases, simple and imprecise syntactic structure
Anomic
Fluent, good with comprehension, good with repeating
Lesion=unknown
Anomia is primary deficit, paraphasia (semantic), circumlocution, frequent pauses, writing is similar to verbal expression, comprehension and reading are typically intact
What are the 2 types of ischemic stroke
Thrombosis= the formation of a STATIONARY blood clot that develops overtime until the artery is blocked
Embolism=debris (clot, plaque, fatty deposit, bubble) carries by the blood stream that can lodge and cause damage
What is used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients (such as TBI)
3 aspects of responsiveness: eye opening, motor response and verbal response
The Glasgow Coma Scale
Which type of dementia is a type of dementia that is caused by a build up of protein (alpha-synuclein) in the cerebral cortex, limbic cortex, hippocampus, midbrain, basal ganglia, the brain stem, and olfactory pathways which results in cellular death (atrophy) and leads to deficits in memory, executive function, motor function, behavior, alertness, sleep/wake cycles and mood, and is commonly associated with hallucinations (visual and auditory).
Lewy Body Disease
Non-fluent, difficulty with comprehension and repeating
Lesion= Large perisylvian, extending deep into white matter, superior and inferior MCA
The most severe type, poor prognosis, profound anomia, communication may only include gesture or facial expressions, stereotypical words/phrases, perseverations
Primary Progressive (PPA)
Subtype of frontotemporal dementia/picks disease
anomia/word finding difficulties are the first symptoms
fluency is impaired as the disease progresses
grammar and comprehension become impaired during middle stages
reading and writing declines over time
typically results in complete loss of speech
Name Stroke Risk factors
age, hypertension, diabetes, a-fib, smoking, obesity, substance abuse, high cholesterol, TIA's, males
Name at least 3 Right Hemisphere Disorder Symptoms
Anosognosia (deficit in awareness of condition)
Left Neglect (hemiagnosia, hemispheric neglect, visual neglect)
Constructional impairments (impairment in forming designs, piercing things together, drawing, identifying relationships between parts to whole)
Topographic impairment (spatial relationships, navigate environment)
Prosopagnosia (inability to recognize faces)
Visuoperceptual impairments (processing visual info, reverse letters, navigating, c/o eyes, blurred vision while reading, loose place when reading, turns head to odd angles, deficits in copying, drawing and writing
Impaired recognition and expression of emotion
Attention impairment= impaired memory, poor following directions, impaired learning
communication impairments- press of speech, reading deficits
Impaired pragmatics-
poor topic maintenance,
frequent topic shifts, poor awareness of the needs of the listener,
impulsive/inhibition related to appropriate topics, comments are often abrupt, insensitive, or “rude”
Comprehension deficits-appreciating humor, figurative language
Which type of dementia
is a type of dementia characterized by severe
short and long term memory loss with relatively intact cognitive function for other domains, is associated with Wernicke’s aphasia/encephalopathy, is caused by a deficiency in Vitamin B-1 (Thiamine), and is typically associated with alcoholism but can be related to other disorders such as malnutrition?
Korsakoff's Disease
Wernicke's
Fluent, poor comprehension, difficulty with repeating
Lesion= Wernicke's area in the superior temporal gyrus
intact grammar, anomia present, circumlocution, empty speech, jargon, press of speech, paraphasias, written resembles verbal production, reading deficits increase with complexity
What type of stroke is hemorrhagic and is caused by a weakened artery that weakens over time/ a pouched or ballooned artery that bursts. Symptoms are usually not recognized or present until rupture occurs.
Aneurysm
Explain the BEFAST acronym for stroke symptoms
B- balance (loss of balance and dizziness)
E- eyes (vision changes, double vision)
F- face (face drooping, especially one side)
A- arm (weakness in arm, especially one side)
S- speech (difficulty speaking)
T- time
T
What lobe of the brain if damaged results in
Spatial awareness deficits: can affect navigation and ability to judge distances
dyscalculia=deficits in math
Body schema disorders: such as left neglect
Parietal
Surgical procedure used to prevent stroke
Involves insertion of a temporary shunt to keep blood flowing while plaque is surgically removed
Usually involves the carotid arteries
Treatment is effective with>70% stenosis, mixedresults in patients with 50-69% stenosis
Endarterectomy (a type of surgery)
Transcortical sensory
Fluent, difficulty with comprehension, good at repeating
Lesion=posterior parieto-temporal
Fluent but has severe anomia which can disrupt the flow of words, perseverations, paraphasias, echolalia, neologisms, writing expression is similar to verbal
lack of awareness
Which hemorrhagic CVA is tangles veins and arteries that increase in size and rupture? They are typically present at birth.
AVM: Arteriovenous malformation
Compare and contrast CVA with TIA
TIAs are temporary while CVA symptoms can be permanent. Both have the same signs, symptoms, and risk factors, except in TIA they resolve quickly and completely. TIAs also have a much better recovery than CVA as CVA can lead to long-term disabilities while TIA increases future stroke risk. CVA can be ischemic or hemorrhagic while TIA is caused by a temporary blockage that resolves quickly.
How many years do we tell clients that they will approximately "recover" from a CVA
2 years
What is given within 3 hours to minimize stroke effects
t-PA (or rTPA)