TACLS-Chapter-2-Body-Structure.pdf Essential Resources

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1 Stroke Network 1. TACLS-Chapter-2-Body-Structure.pdf Essential Resources Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 1

2 Core Knowledge Hemorrhagic 20% Ischemic 80% 10% Subarachnoid (SAH) 10% Intracerebral (ICH) 30% Thrombosis: Large-vessel Disease 30% Embolic 20% Thrombosis: Small-vessel Disease 2 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

3 Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 3

4 4 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

5 Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 5

6 6 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

7 Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 7

8 8 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

9 Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 9

10 10 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

11 Type of Lacunar Syndrome Pure motor hemiparesis Results from an infarct in the internal capsule or pons Contralateral motor hemiparesis with motor aphasia Results from an infarct of the left frontal area with cortical involvement Ataxic hemiparesis Results from an infarct in the pons Dysarthria and clumsy hand syndrome Results from an infarct in the pons or internal capsule Pure sensory stroke Results from an infarct in the thalamus Patient Presentation Contralateral hemiparesis of face, arm and leg, dysarthria Hemiparesis of face, arm and leg with inability to speak Paresis of the contralateral leg and side of the face, ataxia of the contralateral leg and arm Dysarthria, dysphagia, contralateral facial and tongue weakness, paresis and clumsiness of the contralateral arm and hand Contralateral sensory loss to all modalities that usually affect the face, upper and lower extremities, and may be painful Kistler JP, Ropper AH, Martin JB. Cerebrovascular diseases. In: Isselbacher KJ, Braunwald E, Wilson JD, Martin JB, Fauci AS, Kasper DL, eds. Harrison s Principles of Internal Medicine. 13th ed. New York: McGraw Hill; 1994: Fisher,CM. (1991). Lacunar Syndromes, 1, Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 11

12 12 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

13 Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 13

14 14 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

15 Reprinted by permission from Macmillan Publishers Limited: Remodeling of cortical motor representations after stroke: implications for recovery from brain damage (Nudo, R.J., et al), Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 15

16 Reflection 16 Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes Stroke Rehabilitation Unit Orientation

17 References Chakrabarty, A. & Shivane, A. (2008). Pathology of intracerebral haemorrhage. Advances in Clinical Neuroscience and Rehabilitation, 8 (1), Cordingley, G.E. (2006). Intracerebral hemorrhage: Bleeding inside the brain. Retrieved from Duncan, P.W., Goldstein, L.B. Horner, R.D., Landsman, P.B., Samsa G.P., & Matchar, D.B.(1994). Stroke, 25, Heart and Stroke Foundation. (2015). Chapter 2 Body Structure. In Taking Action for Optimal Community and Long-Term Stroke Care: A Resource for Healthcare Providers.,Toronto, ON. Retrieved from Chapter-2-Body-Structure.pdf Ionita, C.C., Xavier, A.R., Kirmani, J.F., Dash, S., Divani, A.A., & Qureshi, A.I. (2005). What proportion of stroke is not explained by classic risk factors. Prevention Cardiology, 8(1), Kistler, J.P., Ropper, A.H., & Martin, J.B. (1994). Cerebrovascular diseases. In K.J. Isselbacher, E. Braunwald, J.D. Wilson, J.B. Martin, A.S. Fauci, & D.L. Kasper (Eds.), Harrison s Principles of Internal Medicine (13th ed.). ( ). New York, NY: McGraw Hill Mandzia, J. (2014). [MRI/CT scans]. London, ON: London Health Sciences Centre. Manno, E.M., Atkinson, J.L., Fulgham, J.R., & Wijdicks, E.F. ( Emerging medical and surgical management strategies in the evaluation and treatment of intracerebral hemorrhage. Mayo Clinic Proceedings. 80(3), Nudo R.J. (1997). Remodeling of cortical motor representations after stroke: Implications for recovery from brain damage. Molecular Psychiatry, 2(3), Nudo, R.J., Plautz, E J., & Milliken, G.W. (1997, December). Adaptive plasticity in primate motor cortex as a consequence of behavioral experience and neuronal injury. Seminars in Neuroscience, 9(1), Southwestern Ontario Stroke Network. (2014). Pathophysiology of stroke, neuroanatomy, and stroke syndromes. In Acute stroke unit orientation (Module 1). Retrieved from Stroke Rehabilitation Unit Orientation Module 1: Pathophysiology of Stroke, Neuroanatomy and Stroke Syndromes 17

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