Stroke

Stroke

Aphasia and speech disorders
1. Mechanism of speech
  1. Wernicke’s area retrieves words, sentencestructure
    1. Sends it to Broca’s area via the ArcuateFasciculus
      1. Broca formulates an action plan
        Sends plan to primary motor cortex
        Primary motor cortex refines it and sends to the cranial nerves for speech muscles via the pyramidal system
Cerebral Blood Flow Regulation Mechanisms
1. Myogenic
  1. Chemical
    1. Cerebral metabolism
      1. Mechanism of action by vasoactive metabolic mediators. (H+, K+, NO)
    2. By PaO2 when <50mmHg: Hypoxia increases CBF by causing cerebral vasodilatation.
      1. ↓pH directly causes vascular smooth muscles dilatation
  2. ↑ in CPP causes ↑ in transmural vessel tension → depolarization of vascular smooth muscle & constriction
2. Risk factors
  1. Non-modifiable
    1. Modifiable
      1. Smoking
        Diet
        Excersice
    2. Age
      1. Genetics
        Gender
Pathology
Prevelance
1. 15 million people suffer stroke worldwide each year. Of these, 5 million die and another 5 million are permanently disabled
  1. Blood supply
    1. Complications
      1. Brain edema
        Pneumonia
        UTI
        Seizures
        Deep Venus thrombosis
  2. Physical examination
    1. Cranial examination
      1. Upper and lower examination
    2. Investigations
      1. CT
        MRI
        Blood tests
        Blood pressure
      2. Management
        reduce the ongoing neurologic injury and decrease mortality and long-term disability
        prevent complications secondary to immobility and neurologic dysfunction
        Prevent stroke recurrence
        Rehabilitations
        Physical
        Psychological
        Socioeconomic

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	Created by Fatima Alkhateeb about 7 years ago