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What is a TACI?
- total anterior circulation infarct
What are the TACI symptoms?
- - hempiparesis and/ or hemisensory lsss
- - visual spatial neglect or global aphasia
- NOTE aphasia is dom hemisphere affected (if not you will have problems with spatial concepts)
- - homonymous hemianopia
What is a PACI?
- partial ant circulation infarct
What are the PACI symptoms?
- - 2 out of 3 comp of tacis
- - dysphasia either expressive or recetive
- - typically NO drowsiness
What is a POCI?
- posterior circulation infarct
What are the symptoms of a POCI?
- - ipsilateral cranial nerve pasies with contralateral sensory/ motor loss
- - vestibular or occular signs
- - isolated cerebellar dysfunction- ataxia/ coordination
- - isolated homonymous hemianopia- loss of vision of one side of both eyes
What is a LACI?
- lacunar infarct
What are the symptoms?
- - discrete symptoms
- - pure motor symptoms
- - pure sensory stroke
- - ataxia hemiparesis
- - dysarthria or clumsy hand syndrome
- - isolate to face and hand
What may affect the chance of survival post stroke?
- - lesion size
- - prolonged unconsciousness
- - increased age
- - severe hypertension- uncontrolable
- - severe co-existing disease- heart disease
- TACI and haemorrhae= bad prognosis
What are the stoke outcomes at the end of the first year?
- - 30% will be deceased
- - 30% will have another stroke
- Of the survivors:
- - 60% will require assistance for ADLs
- - 5% totally dependent
- - 30% of workng age are able to return to work
What are the causes of death for stoke people?
- - effects of ICP esp in ICH
- - infection esp aspiration pneumonia
- - venous thromboembolism
- 1st 48hrs can prevent
What are the symptoms a stroke pt will demonstrate if they have a posterior cerbral artery infarct?
- Visual disturbances
- - contralateral homonymous hemianopsia (central vision is often spared)
- - L hemisphere lesion alexia
- - bilateral lesions: cortical blindness (pts unaware that they cannot se- anton's syndrome)
- Memory impairement if temporal lobe is affected
- Proximal occlusion
- - contralateral hemisensory loss (loss of sensation)
- - spontaneous pain and dysesthesia if thalamus affected (thalamic pain syndrome)
- - contralateral severe proximal chorea (top jerky movts)
What are the symtpoms for a pt with a MCA stroke?
- - Most common
- - contralateral weakness- face, arm and hand
- - contralateral sensory loss- face, arm, and hand
- - visual field cut- damange to optic radiations
- - aphasia- language disturbances- more likely with L Hemi damage esp men. Brocca's production, wernicke's comprehension
- -Impaired spatial perception- more likely after R. Hemi damage, spatial neglect- dressing apraxia, constructional apraxia, topographagnosia (not knowing where u r)
What are the symtpoms for a pt with a ACA stroke?
- - motor disturbance contralateral distal leg
- - urinary incontinence
- - speech disturbance (may be more of a motor problem)
- - apraxia of left arm (sympathetic apraxia) if ant corpus callosum is affected
- - if bilateral may cause apath, motor inertia, and muteness
If you have a stroke that is in the L hemisphere and this is the dominant side what effects will this have on your pt?
- - eg pt right handed
- - controls (R) sided voluntary movts
- - responsible for verbal- analytical activities
What happens if you have a (R) hemisphere infarct? (non dominant)
- - controls (L) sided vol movements
- - responsible for visuo-spatial functions
How can you tell which hemisphere is dominant?
- what hand they use
What is neglect of the left side usually associated with?
- - leison of the non dom hempisphere!
- - there are acceptions