Cerebrovascular disease / KFU- 2.1
-
Upload
qusai-al-rubh -
Category
Health & Medicine
-
view
412 -
download
1
Transcript of Cerebrovascular disease / KFU- 2.1
Cerebrovascular Disease- Stroke
Group#: 5Case 2, Week 3Qussi J. Al-Rebh
TUESDAY 8/9/2016
TUESDAY 8/9/2016
Cerebrovascular disease !• Cerebrovascular disease refers to a group of conditions that affect the circulation of blood to the brain, causing limited or no blood flow to affected areas of the brain.
Cerebrovascular Blood flow in
your brain.
Vascular which means arteries and
veins.
Cerebro large part of
the brain.
TUESDAY 8/9/2016
Case scenario While giving a speech, a 62 – year – old man is suddenly unable to find the right words. He also feels slightly faint. After about 5 minutes he can speak normally again and can also understand everything that is said to him. He has never had a speech disorder like this before; however, he has had two episodes of double vision, lasting 5 and 15 minutes respectively, which disappeared spontaneously. For the past two years he has been treated with anticoagulants after the replacement of his mitral valve.
TUESDAY 8/9/2016
Learning Objectives• What are these Episodes called and what is the probable cause in this patient?• How can the episodes of double vision be explained?
TUESDAY 8/9/2016
Mitral valve replacement:• Cardio surgical procedure in which a patient’s
mitral valve is replaced by a prosthetic valve.
• Performed when the: • (mitral valve stenosis)• (mitral valve regurgitation).
• Patients with these valves must take anticoagulants for life.
TUESDAY 8/9/2016
Anticoagulation drugs:• Prevent blood clots from forming and growing and reduce the risk for heart attack, stroke and blockages in the arteries and veins
• Insufficient dosage of anticoagulant makes the patient susceptible to embolic events
TUESDAY 8/9/2016
Double vision (Diplopia):• A condition where a single object is seen in
duplicate when the image produced by two eyes don’t absolutely match.
• Caused by paralysis or loss of coordination of one or more muscles that control the one eye movement due to a cranial nerve palsy
TUESDAY 8/9/2016
Diplopia:• Normally, eye movement controlled by :• The 3rd cranial nerve (oculomotor nerve) • The 4th cranial nerve (trochlear nerve) • The 6th cranial nerve (abducent nerve)
TUESDAY 8/9/2016
Pathophysiology of diplopia :
TUESDAY 8/9/2016
Aphasia:• Aphasia is an impairment of language, affecting the production or comprehension of speech and the reading or writing could be affected.
• Aphasia is always due to injury to the brain ( head trauma, brain tumors, or infections), most commonly from a stroke
TUESDAY 8/9/2016
Aphasia:• In general, the left hemisphere of the brain is responsible for language and speechand is called the "dominant" hemisphere
• Cause by Damage of Broca’s area or Wernicke's area or both.
TUESDAY 8/9/2016
Aphasia:• The type of aphasia depends on the brain area affected:• Broca’s area lies in the left frontal lobe.• Blood supply : Middle Cerebral Arteries.• If this area is damaged, It called Broca's aphasia • Causes reduced speech fluency with inability to understand what he is saying. • The patient makes great efforts to initiate language, which becomes reduced to a few disjointed words with failure to construct sentences
TUESDAY 8/9/2016
Aphasia:• Wernicke's area lies in the left temporal lobe . • Blood supply : Middle Cerebral Arteries• Damage to this area causes Wernicke's aphasia. • The individual may speak in long sentences that have no meaning, add unnecessary words, and even create new words. • They can make speech sounds, however they have difficulty understanding speech and are therefore unaware of their mistakes.
TUESDAY 8/9/2016
Aphasia:• Global (central) aphasia:• The combination of Broca’s comprehension of Wernicke’s with loss of both language production and understanding.• aphasia and the loss of This is due to widespread damage to speech areas• And is the commonest aphasia
TUESDAY 8/9/2016
Aphasia Pathophysiology:• Due to mitral valve replacement and insufficient anticoagulation, Piece of thrombus on the surface of prosthetic valve broke off•The resulting embolus probable passedreadily through the internal carotid artery Disruption blood supply in the cerebral area of speech Ischemia.•Affect speech area Aphasia
TUESDAY 8/9/2016
what is TIA?•A transient ischemic attack (TIA) — also called a ministroke: A temporary decrease in blood supply to part of your brain causes TIAs, which often last less than five minutes.
TUESDAY 8/9/2016
Signs and Symptoms!?•Stroke symptoms depend on the affected area of the brain.•The main symptoms are “the FAST” symptoms:
TUESDAY 8/9/2016
Risk FactorsHigh bloodpressure
TUESDAY 8/9/2016
TIA Treatment:
Anticlotting drug
antihypertensiv
e therapy internal carotid endarterectomy
Rehabilitation
TUESDAY 8/9/2016
Complications!?
ParalysisEmotional problems
Difficulty talking
central pain syndrome
Memory loss
TUESDAY 8/9/2016
summary• When the single object duplicated, we call it diplopia.• Inability to find the right words or to talk called aphasia.• Which has 3types: Broca’s aphasia, Wernicke aphasia, and global apasia.• TIA is a temporary decrease in the blood supply in the brain.• One of the main causes of TIA in the heart patients is insufficient using of anticoagulation drugs.• The signs and symptoms are “FACT symptoms”.
TUESDAY 8/9/2016
References•http://www.medicalnewstoday.com/articles/184601.php•http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Cerebrovascular%20Disease.aspx•http://www.stroke.org/site/PageServer?pagename=stroke•http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/signs.html•http://www.medicinenet.com/stroke_symptoms_and_treatment/page6.htm•http://www.mayoclinic.org/diseasesconditions/stroke/basics/definition/con-20042884• http://www.uptodate.com/contents/stroke-symptoms-and-dia
gnosis-beyond-the-basics• http://www.nhsggc.org.uk/content/default.asp?page=s1418_
1_1• http://en.wikipedia.org/wiki/Hypoglycemia
• Clinical medicine chapter 22
TUESDAY 8/9/2016